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0115 MAIN STREET (HYANNIS)
�� c� /r' /�!�� ,� ;¢ tip Town of BarnstableIding f i Ei Post This Card So That it is Visible.From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept BARMMAVLL Posted Until Final Inspection Has Been Made. ` Fnwi" Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made.. Permit Permit No. B-17-3745 Applicant Name: KEVIN J FARRELL Approvals Date Issued: 12/05/2017 Current Use: Structure Permit Type: Building-Addition/Alteration-Commercial Expiration Date: 06/05/2018 Foundation: Location: 115 MAIN STREET(HYANNIS),.HYANNIS Map/Lot: 327-202 Zoning District: MS Sheathing: Owner on Record: PISACANO, MARGO Contractor Name: KEVIN J FARRELL Framing: 1 Address: 115 MAIN STREET Contractor License: CS-096560 2 HYANNIS, MA 02601 Est. Project Cost: $ 12,500.00 Chimney: Description: Verizon Wireless Antenna and ancillary equipment on the existing Permit Fee: $ 213.75 eversource utility pole located newar the address 115 Main Street/ Insulation: Fee Paid: $213.75 Pole#33-54 _ Date: 12/5/2017 Final: Project Review Req: ,. Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. All construction;alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: Rough: 1.Foundation or Footing 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low.Voltage Final: 7.Final Inspection before Occupancy Health .Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Final "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire.Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT ��ann+�5 +m►Pt 5C (D TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Z Application # � Health Division ` Date Issued 9 17 W Conservation Division r G ® o� cue � Application Fee , PlanningDept. COM p . � m Permit Fee Date Definitive Plan Approved by Planning Board � 0 Historic - OKH _ Preservation/ HyaKhis 0 Project Street Address 'makh Y N fA t; lU 91 Village Owner V Address ohs- nw�R t k c l- Telephone Permit Request �&[ZrM i,4)\r-ek4P ) 13?a . J 2, h) rnffpnt 1J\166ff 6 &M.-emg- a \ t (c r 1Mat n nt- l¢. k 33- Square feet: 1 st floor: existing DMA proposed n NA 2nd floor: existing proposed __Total new YNIA Zoning District Flood Plain Groundwater Overlay Project Valuatio 5'OD•0a Construction Type Lot Size n \ P, Grandfathered: ❑Yes �WNo If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes \J4 No On Old 'King's Highway: ❑Yes No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area (sq.ft.) r\\pr Basement Unfinished Area (sq.ft) Number of Baths: Full: existing�r new Half: existing -(N' new Number of Bedrooms: n VP1 existing _new Total Room Count (not including baths): existing h new X 1 First Floor Room Count n Heat Type and Fuel: ❑ Gas ❑ Oil D Electric ❑ Other n Ift Central Air: ❑Yes No Fireplaces: Existing New n IH Existing wood/coal stove: ❑Yes No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size-LI - ,�\�Attached garage: ❑ existing ❑ new size —Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes IYNo If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION _ (BUILDER OR HOMEOWNER) O q y a Name 16ejn►n �r���fP�i\ Telephone Number Address o� na Aw •• License# ('S- dQ(oJ(a O Home Improvement Contractor# Email -Vfinemyl CM Worker's Compensation # ux, h[ (pl (0q ALL CONSTRUCTION DEBRIS RESULTING} FROM THIS PROJECT WILL BE TAKEN TO ` lt� �� �a461� U-Inste Maw QJcU nt SIGNATURE DATEoc I I� FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/PARCEL NO. w ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION - FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH - FINAL ' FINAL BUILDING ' DATE CLOSED OUT k' ASSOCIATION PLAN NO. „, ,iy'ai4mmW, Wmn. .. :r,. ”.4b'•" ,. 11 aHIINIrA°,•�.,,yywwlrJll "ypleuhnpury�ll'''rfr,:�op ypi :.I+rlil�lU'4UW� IQm Im quNim�l.::o 11I��Iu11lHLI�i Wu�m• C'� 'al;fyll�„w 'oIJN���ugdu,'''�fh lW ^IN�n.i hllwtlW l " ..xl hl0llii 1WIWulfl� ,':i,� I-�II � -_.q• r r li II 9P�:'•n Wl. -9'^. 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' ,,'NIA h. ;,. .`w`rv: r',r. �,'. ,� 'I vm��''�r:�, I: a' �,� �«: ��; p "�"` 1 ,: '�- �: `°,�� „ a$ , �s II,s t 6 ha.,r i n E g !;:,n ; Ir p r 1:i I mrA±: oil St"; G4 NwN,. % ": t ., �, p 0 R( $ w P �..: .k .:,. ,a ,r,, ", ' .e: ,. " ': ^.i�lh ':.c 'f", 4a,IN. r m u�; W ,,m >,)-+�N .a4,.Y a .',, y.•`,•-; .a aw ::.viol ,: n n,ati9� , • i Y err ,. ^,• n „ "a " "'�1, %.ul ^•r , a a.ti >ttr �, A f -.�'nr-,a, r -'"°*''er•w•- .. ., _ -..... .:aw,..u�st.. ''I�X.L'...,,�i�. � ,�.��.�me.._.:,.:µ:.....:,. ,�W I,�� x,�,:.,.d � r'✓-�»,.�.«;�rwyu�r•: -' IdWrruu��jla'�' W 'um.�& 1.J£v.,,.,,�,�W.u1l�.� - '"ww,. u %..r...��......,�w,�.> ��`Print Forms The Commonwealth of Massachusetts -- a Department of Industrial Accidents Office of Investigations _ I Congress Street, Suite 100 Boston,MA 02114-2017 www.mass.gov%dia Workers'Compensation Insurance Affidavit Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual); New England,Electrical Contracting Corporation Address:21 Marion Drive City/State%Zip:Kingston MA 02364 Phone#:781-585-oo o Are you an:employer?.Check the appropriate box: Type of project(required): 1. ✓❑ I am a;employer with 48 4. ❑1 am a general contractor and 1 6. ❑New construction. employees(full and/or part-.time).* have hired the sub-contractors 2.❑ 1 am a sole proprietor or partner listed,on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition: working forme in an capacity. employees and have workers'' g Y P. tY 9. ❑ Building addition [No workers' comp..insurance comp. insurance.* required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all"work officers have a exercised their I L❑ Plumbing repairs or additions myself. [No workers'comp.. fight.-of exemption per MGL 12.❑ Roof repairs insurance required.]t c. 152,41(4),and we have no employees. [No workers' 11E] Other comp. insurance required.] 'Any applicant that checks bol.#1 must also fill out the'section below showing their workers'compensation policy information. t Homeowners who submit-this affidavit indicating,they are doing all work and then hire outsidecontract6rs.must submit a new affidavit indicating such. *Contractors that check this box'must,attached an additional sheet showing the name of the sub-contractors and state whether or not those entities,have employees. If the"sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. Insurance-Company Name:Zurich American Policy#or Self ins.Lic.#:WCO 61691 Expiration Date:11/13/2Q17 Job Site Address: City/State/Zip: Attach.a.copy of the workers'compensation policy deelaration.page(showing the policynumber and expiration date). Failure tosecure coverage as required under Section 25A of.MGL c.. 152 can lead to the imposition of criminal penalties of fine up to$1,50.0.00 and/or one-year imprisonment,as well as"civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.. Be advised that a copy of this.statement may be forwarded to the Office of Investigations of the.DIA for insurance:coverage verification: I do:hereby certi 'un rn . sins and enalti o er ur" that the fin ormation provided above is true and correct. Simature Date: Phone# Val— 6T . OOL V Official use only. Do not write in this area,to be completed'by city or town offtciaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health I Building Departn►ent 3.City/Town Clerk 4.Electrical.Inspector 5.Plumbing Inspector 6..Other Contact Person: Phone#: r Client#:23780 NEWEN16 ACORD., CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 11/15/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT J Smith NAME: Sullivan Insurance Group, Inc. PHAE° FAX MNL EXe:508 791-2241 a/c,No508 797-3689 1 Mercantile Street ADDRESS: Jsmith@sullivangroup.com Suite 710 INSURER(S)AFFORDING COVERAGE NAIC# Worcester,MA 01608 INSURER A:Gemini Insurance Company INSURED . INSURERB:North River Insurance Company New England Electrical Contracting Corp 21 Marion Drive INSURER C:Zurich American INSURERD:Hanover Insurance Company Kingston,MA 02364 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DD/YYYY MMIDDIYYYY A GENERAL LIABILITY X X VCGP081520 11/131201611/13/201 EACH OCCURRENCE $1000000 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea RENTED $50 000 CLAIMS-MADE 51 OCCUR MED EXP(Any one person) $1 O 000 X BI/PDDed:5,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 17 POLICY X PROJECT LOC $ D AUTOMOBILE LIABILITY X X AWNA947880 11/13/2016 11/13/201 COMBINED SINGLE LIMIT Ea accident 1,000,000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS X AUTOS X HIRED AUTOS X NON-OWNED PRO ER ci-ZtDAMAGE $ AUTOS $ B X UMBRELLA X OCCUR x x 5811075702 11/13/2016 11/13/201 EACH OCCURRENCE $5000000 EXCESS LIAB CLAIMS-MADE AGGREGATE s5,000,000 DED RETENTION$ $ C WORKERS COMPENSATION x WC0161691 11/13/2016 11/13/201 X WCSTATU- OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN N E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? 51 N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space is required) Cert Holder named as additional insured. Policies are primary and non contributory.Policies include Waiver of subrogation. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #303267. KM D 500 North Broadway East Providence, R102914ADD1rCEL Ph:401-354-2403 ENGINEERING GROUP, P.C. Fax:401-633-6354 FAA 2-C SURVEY CERTIFICATION Applicant: Bell Atlantic Mobile of Massachusetts Corporate (d.b.a.Verizon Wireless) 400 Freiberg Parkway Westborough, MA 01581 Site Name: HYANNIS SC10 MA Site Address: Utility Pole#33-54 115 Main Street HYANNIS• MA 02601 Horizontal Datum: ® GPS survey ®Ground survey Vertical Datum: NAVD 1988(AMSL) ®GPS survey ®Ground survey Structure Type: ❑New Tower ❑Existing Tower ❑Roof Top ❑Water Tank ❑Smoke Stack ®Utility Pole Latitude: N 410 39'20.59" NAD83 Longitude: W-700 16'29.69" NAD83 Ground Elevation: 0' (AGL) 28AY (AMSL) Top of Existing Utility Pole: 28.5' (AGL) 56.5' (AMSL) Centerline of Prop.Antennas: 34.6' (AGL) 62.6' (AMSL) Overall Height of Proposed Structure, Including Appurtenances: 36.4' (AGL) 64.4' (AMSL) Overall Height of Existing Structure, Including Appurtenances: 28.5' (AGL) 56.5' (AMSL) Certification: I certify that the latitude and longitude are accurate to within +/-50 feet horizontally and that the ground elevation is accurate to within +/-20 feet vertically. The horizontal datum (coordinates)are expressed in terms of degrees, minutes, seconds and tenths of seconds. The vertical datum (heights)are expressed in terms of feet. Company: Advanced Engineering Group, PC Professional Engineer: Scott N. Adams, P.E.#46006 �+ Date: 02-27-2017 Cft mIIAL ? SIGNATURE/SEAL I APPENDIX IV Form 1 APPLICATION AND POLE ATTACHMENT LICCIVSE: Licensee VERIZON WIRELESS Street Address ONE VERIZON WAY,MAIL STOP 4AW 100 1 City,State and Zip BASKING,RIDGE NEW JERSEY 07920 I Date 2/22/17 In accordance with the terms and conditions of the Pole Attachment Agreement,application is hereby made for a license to make 1 Antenna attachments)to pole#33-54 located in the municipality of Hyannis in the State of MASSACHUSETTS. This request will be designated Pole Attachment License Application Number HyannisMASClo-403626 Attached are my power supply specifications if applicable.The cable's strand size is 0.5 and weight per foot of cable is 0.2. Communication Sync e Power[Supply Space Licensee's Name(Print)VERIZON WIRELESS By. Name Barbara Kassabian Signature 150W CWW7(.a*a.l AW I NSTAR d/b/a EVERSOURCE Power Company Title Site Acquisition Tel.No.603-303-8001 Fax No. E-mail bassabian@trmcom.com *********************For licensor use,do not write below this Pole Attachment License Application Number is hereby granted to make the attachments described in this application to attachments to JO'poles, attachments to F02 poles, attachments to JV poles, Power Supplies and other attachments located ! in the municipality of in the State of as indicated on the attached I Form 3, Licenser's Name(Print),— Signature (AGREEMENT ID#) Title rj(>-k('U\S G- Date Tel.No. l i . 4 The Licensee shall submit an original copy of this application to Verizon New England Inc.and NSTAR Electric Company d/b/a EVERSOURCE ENERGY. Revised 02/23/2015 NSTAR d/b/a EVERSOURCE - i 1 - I r Form 2 i AUTHORIZATION FOR FIELD SURVEY WORK Licensee: Verizon Wireless In accordance with Article III&Appendix I of the Pole Attachment Agreement, following is a summary of the charges which will apply to complete a field survey covering Pole Attachment License Application Number t minisMAsf ta-403626 in the municipality of Hyannis in the State of Massachusetts FIELD SURVEY CHARGES Field Survev #Poles Unit-Rate Total Field Survey Application Fee 1 Pole $139.00 $ 139.00 (includes Istpole) Field Survey 2-200 Poles $ 13.45 per Pole $ Additional Travel Time* $?OQ 0_0ger-Day $ E TOTAL Charges $$139.00 *Based on average of 75 poles surveyed per day,add$200.00 travel time for each additional day required to complete survey. Please note,if you calculated the cost incorrectly,your check will be returned and a new check for the correct amount must be received by this office in order to schedule the survey. If you need assistance,please call the HOTLINE on 800-340-9922. The required field survey covering Pole Attachment License Application# HyannisMASCIo-403626 is authorized.I am enclosing an advance payment in the amount of$ 139.00. 1 Licensee's Name(Print)Barbara Kassabian i k Signature 13CWbVtW'a Ka41alit a w i Title Site Acquisition Address 16 Chestnut St,Suite 420,Foxboro,MA 02035 Tel.No. 603-303-8001 Date 2/22117 Revised 03/06/2015 Eversource Energy FORM 3—EVERSOURCE ITEMIZED Pole Make-Ready Work Charges PAGE OF RCE to Complete: Total Poles Surveyed Total Poles Requiring NSTAR Make-Ready Appendix IV Form 3 FMT;D,,SUR.YEY-..Z.i MARE READY=WORK�F.ORK SURVEYORS: DATE OF SURVEY: CWO #: Verizon MUAIC. Hrmnis STATE: MA Exch Code: Munic Code: Licensee Barbara Kassabian LICENSEE NAME: Vertzon Wireless LICENSEE APPLICATION#: H annisMASC10-403626 EVERSOURCE ' ELCO NAME:EVERSOURCE 'NSTAR APPLICATION# a LOCATIQN POLE#;.,ATT -_ _.''t 1 ERS8IP'•_ GHARGT!• . T WORK DESCRIPTION TEL RTE/STREET AMME Tel El F/C J.O. J.U. F.O. YES NO TASK#S / * Height List one pole per line P.S. Tel Et Tel EI Tel El REMARKS of Att. Rise r 110 Main Street 33-54 NI i TOTALS: HLAot of Attachment=Heijghtof Licensee Attachment shaU be.40"below,ELCO MG1V ualess otherwise noted here;hY V.erizaa and EWRSOURCE sarve r. Revised 03/06/2015 t ' EVERS=URGE - Work Order Application yy; FOR KEN KENDRICK: i Customer Request In-Service Date:,51.22117 WO Received Date: _ Service Address:Street: Suite:,,,,,,_Town:livannis __Zip: 02601 Customer Of Record: Customer Responsible for Payment of Monthly Electric Bills Name to appear on Monthly Bill:Cellc-Q Partnership DBA—C/O Name: Verizon Wireless Billing Address: P-.O.Box 2375,Spokane..WA_99210-2375,. Telephone:866-322-4574 _ Tax ID Number: 22-3372889 Existing Account or Meter Number(if applicable): Property Owner Name(if different from above): Owner Address: Owner Phone Number: Party Responsible for Construction costs associated with work order(if different from above) i Name:Verizgn Wireless I Address: 118FJanders.Road.-3rd-Fl9or.-Weslborouuh.. A.01581_ Phone Number.5M-320-2017 Please Note that Articles of Incorporation are required for new commercial EVERSOURCE Customers Type of Service Requested: (Circle Appropriate) X New Service Service Upgrade Service Relocation Temporary Service Pole Relocation Disconnect/Reconnect Service Removal Metering Only OH Service from Pole, Pole#: UG Service from; Riser-Pole#: Padmount#' Customer Loading Brief Description of Work Attach_(1.)__ame-nna _(2)_RRH/Cabinet_.-and, TYpe of Load New Connected Load in KVA W meter-to_the_Aole.Will_reauire_60-amp _Single Phase Three Phase 11 single phase service. 11 Li htin Electric heat - ` Air Conditionin `_ _ Refrigeration, Cooking-----, Electric Dryer_ Water Heater computer Process Equip. 14.4 Motors/Elevators-_ Miscellaneous Totals 14.4 Number of Meters Required: Residential: Commercial:I Public: Main Switch Voltage: Amperage:__ Phase: # Service Voltage: Amperage:_ Phase:_ 1 Facility Type(ie:school, hospital): Telecommunications New Building Square Feet: ALL 480V SERVICES REQUIRE COLD SEQUENCE METERING(DISCONNECT SWITCH ON THE LINE SIDE OF THE METER If more than 1 meter is required, how will meters be labeled?(ie: Unit 1,2,etc, Unit A, B,etc.) .....- - i { a Additional Equipment: t Generator: KW: Phase: Purpose: Motor(S) : Total#.: Largest HP: Phase: Locked Rotor AMP: I !: Type of Starting Compensation(choose one): Hard Soft Capacitor VFD f i *See Article 802 of EVERSOURCE Information and Requirements Book for Maximum LR current and Three Phase Protection* Contact Name(circle appropriate): Customer/Contractor/Consultant: Barbaraxassabian Street Address: 16 Chestnut-Street,Suite 420 City, State, Zip: Foxboro, MA 02035 Telephone: Best Time to Call:Monday-Fridav s a.m.to s am. Pager: Fax: Cell: 603-303-8001 Electrician: .TBD License Number: Business Name:Verizon-Wireless Street Address: 118 Flanders Road,3rd Floor :City, State, Zip Westborough.MA 01581 Telephone: 508-320-2017 Best Time to Call: Pager: Fax: Cell: Please note that by Interconnecting with the EVERSOURCE Distribution System the Customer of Record 3 acknowledges that they have reviewed and are in compliance with the EVERSOURCE Information & Requirements for Electric Service(Blue Book). For New Commercial Services, New Residential Developments, New 13.3 kv Two Line Station Electric Service, please provide (2) copies of City/Town approved site plans that illustrates the new facility location and the proposed location of the new utilities(electric,gas,water,sewer,telecommunications)and a One-Line Diagram. For Service Increases at existing facilities,please submit a One-Line Diagram if available. For New Residential Services where a pole must be set,please provide(2)copies of a site plan that illustrates the proposed location of the new facilities. For Temporary Service Requests,please provide(2)copies of a site plan illustrating service location. You may Fax this Form or mail any additional correspondence to: i EVERSOURCE ENERGY Electric and Gas One NSTAR Way Westwood, MA,02090 Tel: (781)441—3851 Fax:(781)441-3194 Cell: 339-987-7059 H. Kendrick SW340 j FOR NSTAR USE ONLY EVERSOURCE Revenue Allowance: EVERSOURCE Rate: KVA or KW rating of Existing Loads(if applicable): Existing Winter Peak Demand: Month/Date/Year: Existing Summer Peak Demand: Month/Date/Year: t l j I l . s� '$'�w� z p9�`,✓ � �'� ..a� �q•i"Y� \'°� �q�r...P. � } .'tl •�.. i i� A" Yrf. 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INSTAI I ATION NOTE ` INSTALL ALL EQUIPMENT, MOUNTING - BRACKETS AND HARDWARE RI • +t A!YY�R[>aN!E WITH MAAUFACIURER'S - RECOMMENDATIONS ELECTRICAL NOTE,• GENERAL WIRING DNGRAM AND NOTES TAKEN FROM E-MEMO BY JAMES F.GVAZDAUSKAS. P.E. - qI ao•� ` DATED JANUARY. 12 2017 u a J. COORDINATED NOTE: -' COORDINATES AND AMSL ELEVATION BASED FROM FAA-2C CERTIFICATION DATED 00/09/2016. A METES AND BOUNDS SURVEY WAS NOT CONDUCTED LEGEND try (P) - NTURL(01Al7T) (L) EASTRNG(YELLOW) (P) PROPOSED(BLACK) APPROX. LOCATION(E) UTILITY POLE TRUE NDRrH 451� (AGL) = ABOVE GROUND LEVEL SUBJECT POLE FALLS WDT6il THE (AMSL) = ABOVE MEAN SEA LEVEL. NAD 83 LATITUDE: 41.39' 20.59• , SITE PLAN TDWt9l's RIGHT OF WAY. N.T.S. = NOT TO SLUE NAD B3 LONGITUDE -7P 16' 29.69' MASSDOT HIGHWAY LAYOUT PLAN(WHITE) �-/ LE-1 SCALE: 1'-50' 0; 25 50' IV GROUND ELEVATION: 28.0'AMSL HYANNIS_SC10 MA LEASE EXHIBIT DATE: 02/10/2017 V- — DRAWN BY: JWH vet �twireless ADVANCED DRAWING NUMBER REVISION CHECKED BY: SNA ENGINEERING GROUP,P.C. 110 MAIN STREET Civil Engineering-SiteDevel V0 FAIN WIRELESS HYANNIS, MA 02601 SCALE: 1"=50 Development 400 N°RIBERG PARKWAY HYANNIS_SC10_MA 3 Surveying-Teleeommwticafions WESTBOROUGH, MA 01561 SHEET: 1 OF 5 } m. 4' (P) 12.0'1 X 38.7H NH3�k-�DC-W TOP(0) ANTENNA MOUNTm TO(PI UTIM POLE' OLE t3EV 3S 4#Aq (84:4'k , ° (P)120•0 x 38,7'H NH3600M-DG-2W p "'04c _ ANTENNA P MOUNFED OL TO(q (P)ANTENNA GROUND WIRE — IL OF(P)AMM&A st ELEY.=34.6t AGL(62 8't AMSL) (q TALL 1482011 (P)4'WDIS10N POLE (TOTAL Of 2) dt(I)RET TOP(T0.UIIUTY PO(P)Jr CONE CABLES a LE UT1UTY Lm POLE i37-54 CABLE IN 2'U-0UARD'TO (P)ANTENNA � (P)POWER 1rEATFffRIiEM ELEV. = 28:5't AGL(55.5•t Ate.). ? E _ SECUCARY POWER'UNE `I* EI"(25A'3 AZ1 uA nVSi _ M. 26.0 t AGL 54.47 t AN,SU � —w BOTTOM OF SiRE'ET Lr-KT AMA ELEV. 24S s AGL _ s *XM E "tctC0 COAX EEW 22:a Aw +:o -- — (Ef . ;� (P)rtrw s(Toro of 2), (z)(P) — - 28.5'TALL VERIZON UTILITY POLE/3S st v DFID &( DELTA CO (_ MCI)CQA LAC�OC CONVERTERS E1i5 MOUNTED Lt.2 5 z 78 5't A tStp. (P)RRH S.(TOTAL OF 2), (2)(P)OtPI£XM& (2)(P) F & m(q IIITITTY POLE DELTA AC,/DC CONVERTERS,MOUNTED TO(E)UTILITY POLE . (P) POWER TO(P)METER FROM PROUDER (P)FIBER.2'U- lMRO TO(P)SAR-0 WMYA OF(0)RRH (MPP) (P)1£'COAT(CABLES(TOTAL OF 4)TO DIPIEXINS ELEV. - 12:5t AGL'(40,V*AMSL) (P)5►R O 6M-2 POLE DISCONNECT (P) ELEC. RGS SNrfCH FUSED WITH(3)-20A CONDUIT TO(P)METER tiRW1T BREAKERS&METER ; 6OA-2 POLE DISCONNECT SWRCH R15ED WITH b N (3)-20A CIRCUIT BREAKERS k METER SOCKET -_ tti (P)GROUND WIRE FROM(P) MM TO(P)GROUND ROD (P)MMUMM ROD PHOTO ELEVATION SCALE. r=iO' LEGEND (), ) I ELEVATION tem, emvTLiRy NM (q = EXSIM(G[t£Y) INSTALL ALL EOWMEIIT, MOUNTING. A STRUCTURAL ANALYSIS SHALL BE LE-2 SCALE 1�10' POLE jA PRCPOSID'(BLACE 0 S' 10, 2D' �ORDANCEE WITH MANUFACTURER'S COONsn ACTION CKEIS AND HARDWARE IN PERFORM ON DMW Nm SHALL (ut) aT�c cRua�Ltxi RECOMMENDATIONS BE THE RESPMBNTY OF UTILITY 00. Rts NOT To SCALE � f� HYANNIS_SC10_MA LEASE EXHIBIT DATE: 02/10/2017 1/ DRAWN BY: JWN ADVANCED 110 MAIN STREET DRAWING NUMBER REVISION CHECKED BY: SNA ENGINEERING GROUP, P.C. VERIZON WIRELESS SCALE: AS NOTED CHEogineering-SiteDevelopment 400 FRIBERG PARKWAY HYANNIS, MA 02601 HYANNIS_SC10_MA 3 Surveying-Telecommvnicatiow WESTBOROUGH, MA 01581 SHEET: 2 OF 5 INSTALLATION NOTE _... ., INSTALL ALL E0UFMEWr,MOUNTING y BRACKETS AND ILARMARE IN ACCORDANCE WITH YANUFACII1RfR'S (P) T2.1Y1 X 38.7H REOOM ENfATIOHS (E)OVERHEAD ELECTRIC ' TOL380OL1-DCr2XR ANTENNA MOUNTED TO (P)InuTY POLE i STRUC_naad NOTE A STRUCTURAL ANALYSIS SHALL BE.. (p;CONCRETE sIITEWMx PERFORMED ON T7wm un m POLE PRIOR TO CONSTRUCTION AND SHALL' (P) 12.0'0 X 38.71M BE THE RESPONSmR111 OF UrIL11Y Co. M-DO-z7O1'ANTENNA (P)4 ExrENssION POLE(E) STREET UGHr NN3600 (E) OVERHEAD ELECTRIC MOUNTED TO(P)UTI1111 POLE (P)AN FM.(P)PCS RIK(P)AC/DC VERIZON Z CONVERTER.(2)(P)OELTA AC/DC CONVERTERS. (E)28.5'TALL 33-54 (E 211.5'TAIL YMON (2)(P)-OWU)6EtS.60 MAP METER SOCKET UTILITY POLE/33-54 U)T'TY POLE 03-54 MQUNTm TO(P)U11U}1'POLE 1161E mm / 4 ANTENNA P ANTENNA MOUNTING DETAIL u✓ LE-3 SCALE 1•.8' lE-3 SG1LE 1��4' (P)4' EXTENSION POLE 1 3F _ 7.3' C011lom -w-mm ..: ^"(( �' I '��• 'DIML715tON5: i2: 11>e 38:- * 1 WEIGHT: 33.7 1J95 jL -ilia _. -- � 17 ot �� � " DLPI.Exer LEGEND ,> : 7. X 73 x sz ��Eh. �"i Arfs aon wel :. WEIGHT* 8.6 LB6 LUT E MMIT tna 1H8 = a -- (F) • MM MACK) NOTE: MOUNT DIPLE70R5 TO BACKSIDE ( E ( } , OF�—�EW PROPOSED 8l mQ ANTENNA DETAIL z RRH DETAILS (AST} AM 0MV LIM j f-3 SCOM N.Ta -s SCALE N.T.S. 3 DIPLEXER DETAIL (mm) = am VEAN SEA wa lJ 3 SCALE N T S ILT.S ¢ NOT 10 SCARE HYANNIS_SC10_MA LEASE EXHIBIT DATE: 02/10/2017 DRAWN BY: JWH ADVANCED DRAWING NUMBER REVISION CHECKED BY: SNA ENGINEERING GROUP, P.C. 110 MAIN STREET vERIzoN IWTtELE55 3 SCALE; AS NOTED eve ClvilEogmeeeing-SiteDlopment 400 FRIBERG PARKWAY HYANNIS, MA 02501 HYANNIS_SC10-MA Surveying-Telecommunications WESTBOROUGH. MA 01581 SHEET: 3 OF 5 PROPOSED Mn1rNA ANTENNA MOUNT/BRACKET ANTENNA GROUNDING (2)1/2'COAX CABLES&(1)RET �0��ON AN IDI A CABLE IN 2'W RATED U-GUARDS 4. SECONDARY LINES 4. N VrEMM NW(LEAVE-10' CONDUCTORS FOR LMUTY' CO.Tit INS) FIBER FRONnWA & BACKHAL1 4 FIBER OEWRRC ON POLE (2)DIPLEXER FAR JUMPERS IN 1-1/2'W _ (4) 1/2'COAX RATED U-GUARD IF LENGTH CABLES EXCEEDS 4' PCS AYPC�.WIRE IN FIBER JUMPER(TYP.) - AWS H RRF1 1-1/4-W RATED,PVC DC POWER n ANG COPPER GROUND DELTA AC/DC CONVERTER (TYP. OF 2) WEATHER PROOF SQUARE D CAT Ac POMER N01E USE PROVIDED DELTA NO.:SDSAII75 SECONDARY SURGE MANUFACTURERS WRING AFRE510R ON 20A 2P CIRCUIT BREAW /2 ANG COPPER SQUARE 0 aO-IOOA,8 SPACE. 16 CIR OUTDOOR Q: GROUND IN 1/2' MAIN LOAD CENTER WITH COVER. 60A 2P MNN UV-RATED PVC IXRCtUtT BREAKER-WITH(3)20A 2P BRANCH CIRCUIT -MAKERS(1,FOR SURGE ARRESTOR_&(1)PER RRIO MILBMIX CAT NO.: U2272-RL-ST9-4L SINGLE LINER 3/4'Ia10'COPPER 120/240V, 1#]W 125A METQR CLAD GROUND ROD ELECTRCeL NOM' GENERAL MOW 1 GENERAL WIRING DIAGRAM NOTES TAM FROM E-ME O BY LE-4 SCALE N TS JAYR F.GVAZDAlISKAS,P.E DATED JANUARY 12, 2017 HYANNIS SC10 MA LEASE EXHIBIT DATE: 02/10/2017 �- rwess DRAWN BY: JWH !lADVANCEIDDRAWING NUMBER REVISION CHECKED BY: SNA ENGINEERING GROUP, P.C. 110 MAIN STREET VERRON WIRELESS HYANNIS, MA 02601 SCALE: AS NOTED CinTEngineering-SitcDeveloproent 400 FRIBERG PARKWAY HYANNIS_SC10_MA 3 Smveying.Telecommunications WIFSTBOROUGH. 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HYANNIS SC10_MA LEASE EXHIBIT DATE: 02/10/2017 / — DRAWN BY: JINH ADVANCED ltet3A-4_20►Wheless DRAWING NUMBER REVISION CHECKED BY: SNA ENGINEERING GROUP, P.C. 110 MAIN STREET VER120N WIRELESS SCALE: AS NOTED Civil Engineering-SiteDe Iopfmt 400 FRISERG PARKWAY HYANNIS, MA 02601 HYANNIS_SC10_MA 3 Surveying-Telecomumnicaions WESTBOROUGH. MA 01581 SHEET: 5 OF 5 ,4 i g 0 verizonwire-less July2,20.:15: Dear-Sir/Madai: Re TRM, Inc.. Please;accept this letter,as notification.that TRM;;Inc.,of Foxbo.rough,'Massachusetts has been engaged to perform research on certain properties and real estate Jncluding submitfirig;for zoning approval, building permits and negotiating;real estate agreement&as well as engage-in certain.-engineering analysis and constructionfor Verizon Wireless':ongoing:network enhancement: TRM, Inc.,'is authorized to act on-Ver¢on Wireless' behalf for the purpose of filing and consurrimating,any i zoning and/or building'permit applications necessary to obtain approval of thel applicablejurisdiction.for the.,installation and/or modification of Verizon Wireless'communications facilities. Should you have any questions regarding any TRM, lnc's activities on.behalf of Verizon Wifeless, feel free to contact me at 5087320-2017'or via email at scan,conway@verizonWireless,com: Resp ctfully;, Sean Conway Verizon Wireless Project Manager—Real Estate V4 veri onwireless May 9, 2017 Dear Sir/Madam: Re: Kevin Farrell/NEEC Please accept this letter as notification that Keven Farrell working for NEEC, of Kingston, MA has been engaged to perform research on certain properties and real estate including submitting for zoning approval, building permits,and construction for Verizon Wireless'ongoing network enhancement. Keven Farrell / NEEC is authorized to act on Verizon Wireless behalf for the purpose of filing and consummating any zoning and/or building permit applications necessary to obtain approval of the applicable jurisdiction for the installation and/or modification of Verizon Wireless' communication Facilities. Should you have any questions regarding this please contact me at 508-942-7503 or via email at nnpelletier@trmcom.com. Zectfully,� Sean Conway Verizon Wireless Project Mamanger—Real Eastate i MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION Two Center Plaza Boston,Massachusetts 02108-1904. (617)723-3800 Ma Only(800)392-6108,FAX(800)851-8424 3/16/2017 Form of Notice of Casualty Loss to Building Under Mass.Gen.Laws,Ch.139,Sec.36 HYANNIS BUILDING DEPT 200 MAIN ST HYANNIS MA 02601 t Re: Insured: CAPE COD RECOVERY LLC AND Property Address: 115 MAIN ST, HYANNIS,MA 02601 �M Policy Number: 1420671 V1w Type Loss: Water Damage:All Other Water Damage ` Date of Loss: 03/14/2017 Claim Number: 412941 Claim has been made involving loss,damage or destruction of the above captioned property,which may either exceed$1000.00 or cause Massachusetts General Laws,Chapter 143,section 6 to be applicable. If any notice under Massachusetts General Laws,Chapter)39,Section 3B is appropriate,please direct it to the attention of the writer and include a reference to the captioned insured,location,policy number,date of loss and claim or file number. MPIUA Claims Division CMA00021 I t I►)ZZI�c The Law Office of DAVID V. LAWLER, PC 540 Main Street, Suite 8 Hyannis, MA 02601 Telephone: (508) 778-0303 Facsimile: (508) 778-4600 962 Main Street Email Address: Osterville, MA 02655 Dlawler.atty@verizon.net Telephone:(508) 428- 0542 November 14, 2016 Paul Roma, Acting Building Inspector Town of Barnstable 367 Main Street Hyannis, MA 02601 Re: 115 Main St, Hyannis, MA Dear Mr. Building Inspector: This letter is in follow-up of our meeting at the Town Annex with Robin Anderson and Jeffrey Lauzon. The purpose of this letter is to confirm my understanding of the meeting. Specifically, the discussions involved the property at 115 Main Street, Hyannis, Massachusetts for the potential use as detailed in an application for a Regulatory Agreement, specifically being an overnight facility for individuals seeking treatment for drug and/or alcohol abuse, those individuals for the purposes of the Code being disabled. It was agreed that the facility as configured at 115 Main Street could hold up to 16 beds for such individuals, provided that prior to occupancy for such a use that a residential fire suppression system be installed and approved by Building and/or Fire Departments. Again, this letter constitutes a request to confirm the information addressed above. As always, I thank you for your courtesies and time in dealing with these matters. BUILDING DEPf Ve my your NOV 15 2016 / Davi . L r TOWN OF SARNSTABLV o • J 4 .ISSIONER, 200 MAIN STREET,HYANNIS, MA 02601 ach building or structure or part thereof to be certified. e issued. change in the above information. EXPIRATION DATE: DIME, Town of Barnstable Regulatory Services MUMSTA13LE Richard Scali,Director �b1639. Building Division 'OrEn �p Paul Roma,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 September 12, 2016 Gail Hanley, Clerk Cape Cod Commission P. O. Box 226 Barnstable, MA 02630 RE: Jurisdictional Determination for Downtown Hyannis Regulatory Agreement 115 Main Street Project- 115 Main..Street, Hyannis ,Map 327, Parcel-202_,' Dear Ms. Hanley: I am writing pursuant to Cape Cod Commission Regulations, Chapter D, Development Agreement Regulations Governing the provisions for Development Agreements, Barnstable County Ordinance 92-1, as amended through July 19, 2005, Section 6(b), and Chapter 168 of the Barnstable Code. This letter is to inform you that the Town has received a request for a regulatory agreement for the property located at 115 Main Street,Hyannis, Massachusetts. The proposal is to request to allow sober rehabilitation with overnight stays 30 to 90 days, not allowable by law. .There are no significant changes to the structure proposed. A copy of the Regulatory Agreement Application is enclosed for your files. I have determined that the proposed development is not a Development of Regional Impact at this time for the following reasons: The proposed development does not meet or exceed one or more of the Cape Cod Commission mandatory thresholds for review-as a Development of Regional Impact as set forth in the Cape Cod Commission Enabling Regulations, Chapter A, Section 3. The proposed development is located in the Hyannis Growth Incentive Zone (GIZ) as approved by the Cape Cod Commission by decision dated April 6, 2006, and the proposed development is included within the area authorized by Barnstable County Ordinance 2006-06 establishing a cumulative development threshold within the GIZ, under which this development may proceed. In addition, the project does not meet or exceed the DRI Thresholds established under Condition#G9 of the Cape Cod Commission Decision authorizing the Downtown Hyannis Growth Incentive Zone, dated April 6, 2006, as follows: 1. The project is not an addition or expansion associated with the Cape Cod Hospital. 2. The project is not a proposed demolition or substantial alteration of an historic structure or destruction or substantial alteration to an historic or archaeological site listed with the National Register of Historic Places or Massachusetts Register of Historic Places, outside a municipal historic district or outside the Old King's Highway Regional Historic District; 3. The project does not provide facilities for transportation to or from Barnstable County, including but not limited to ferry,bus, rail, trucking terminals,transfer stations, air transportation and/or accessory uses,parking or storage facilities, and any auxiliary or accessory uses are not greater than 10,000 s.f. of Gross Floor Area or 40,000 s.f. of outdoor area; and 4. As represented by the applicant, the project does not require an Environmental Impact Report under MEPA. Please contact me if you have any questions regarding this matter. r Sincerely, Paul Roma Building Commissioner CC: David Lawler, Esq. Q R g) The Town of Barnst.ab e �o.. y Planning Board 200 hilain:Street,Hyannis;MA 02601 Office: 508-862-4786 Fax:. 508-862-4725 JURISDICTIONAL.DETERMINATION ....REGULATORY AGREEMENT HYANNIS VILLAGE ZON[NG DISTRIGT8 Pursuant to S.ectior 168 ofi:the Barnstable Code,.this Jurisdictional De.terrrrination'Form establishes whether an:applicant may enter into wtwo pa:rtyRegutatory Agreement with the Town of Barnstable. This form shall be submitted to the Barnstable Bullding.Cotrimissio.ner, The.Bathstabae Building Comrnissione.rshall.at theit.sole discretion, determine when a Jurisdictional Determination Application is com:plefe acid will cantd. ct the.applicant when a determination has been made The.Bui.lding . Commissioner may request additionalri for-mation if necessary. A projeetproponenf:may seek fo enter Into.a..Reg6..1 tory Agreerien.t.WITHOUT the:Cape Cod Cammssion as a party if the:proposed project Is NOT the type of;project;excluded from the Hyannis Growth Fnceritive Zone(at cumutatiire thre hofid. (Stated .another way; file Gape Cod Commission must be a party to the:Agreement if tFte.project Is th:e aype that does:not::qualify for file GIZ.cumuaative. threshold.} As required by Section 168 a copy of fhis Jurisd''ictiona:I Determination Form,will be:forwarded toahe Cape Cod Commission_ Submit three(3 copies of the following to the Town.of Barnstable Building,Commissioner: (1):JurisdJctiohall Determination From:.Please note that Jurisdictio'naC Determination Forms do not require the.submission of an abutters list: (2) Completed:Reguliatory Agreement:Application incl.uding all subrn'ission:requirements APPLICANT: OWNER IN:FO:RMATION. Applica.rit Namel:c_ap:e:Cod Recovery,LLC_Phone-. 508,-778-0303 Applicant Address: c/o David V.Lawler,540 Main St.,Suite:8.,Hyannis,MA 02601 A- ppbeast.EmailAddress.dlawle_ratty. :verizon.net Property Owner(if.d.iffere ct).Ma:rgo PisacaAo. Pho.ne::, 508-248-4443 Address of Owner(if different) 73 Harbor Bluff HyannisQort,_MA;: IfapplicAat differs from owner;state n'atui'e of interest:2-APpji.canthas th�ro ierty.underth,e attached purchase and sales:agreern t.Al?.plica:nt_is.the_N'am:inee_of:the Buyer TI*Appiicara Nathe:.will;tie ah;e entity in whose.name the Reg.lato y Agreement v�iill issue. . 1 PROPERTY INFORMATION. Property.Assessor'S.Map/Parcel:Nu nber(s) 327/202 Property Address: 115 Main Street: a_nnisNA 01601 Deed a ecordin:g;Bonk. 21249 Page.28:8 Plan Record'.in.g Plan Book 108 Page 21 Zoni.ng:Dastrict : Ms.. .._.. ..:...... .:..: . . .. Number o>`Years'Owried: _3_ !, Totall land.area subject to the.Regulatory Agree.rnent:41 Acres PROJECT INFORMATI;O_N. Project Name: 115 Main�tr•eet Proiect. Regulatory Agreement Requested: See Attached Gross FloorArea3 of all existing budding$:_3153+.b Gross Floor Area of all proposed de mohtlo.n: N.on.e Gross Floor Area.of:a.11'nowh.uild►ngs: None Net.Gross Floor Area of buildings/structures: .same;as existing,.,no change._,.._................ ____ if pore th*an:orie land users proposed,Gross-Floor Area of each proposed use'with a.brief d:eserip..tioi.i of each.rise: Total number of residential.uni.ts.p,roposed not.applscable QUALiE1CAT10N_TO PROCEED WITHOUT CAPt,COD COMMISSION PARTiciPATION. z If the applicant differs from:.owne.r,fhe,applicant will..be required to:submit one original notarized letter authorizing 'the application,a'copy of on.executed purchase&sales Agreement:or lease,or other documents to prove standing and interest in the property: For these purposes Gross Floor Area Is defined as: "The:sum:'of the area of all floors within the perimeter of a building, located either above or befow ground level, except underground parking within the structure and:accessory to the principal use shall not be included in the total gross.floor area.Gross Floor Area shall be expressed in square feet and measured from the exterior.face of the ezferior walls, or,the.centerline of shared walls. It shall include all floor,levels including basemerifs mezzanines.:and attics wiihout deduction.for,hallways, stairways; elevator:shafts, mechanical ro6ms,:closets, thickness:of walls, columns or other similar feafures. Outdoor areas used for storage, sales,:service and display shall.also be included;in the total Gross Floor.Area-. 2. i 1. .l.s the project located within the Hyannis Main StreetWaterfr.ont Historic-District(HM•SWHD)? Yes.O No X If the project is NOT located within the H.MSVV- D., does the project propose demolition or substantial alteration of an historic structure or destriietion or substantial alteration to an historic or archaeological.site listed wifh the:National&.jster of Historic Places or Massachusetts ReCIL ter. flfHistoric:Places? 'Yes 0 No X . If yes, explain what, if any, part of the structure:or site:is proposed to be.clemolished or substantially altered and the natute of the proposed alteration:. No change to exterior of structure 2. Is the project an.addition or expansion associatedW.ith the Cape Cod Hospital that meets o`r exceeds a DRI threshold? Yes 0 'No:X 3. D.oes the project provide.facilities fo,r`transportation to or from Barnstable County, including but not limited to ferry;lies;.rail,trucking term__inals;transfer stations,air transportation and/or . accessory rises,parking of storage facilities.;and:any auxiliary or accessory uses greater than 10,000 SF of Gross Floor A ea or 4'0;000 SF of ouadoor area?.Yes:0 No X. 4..Does the project require:the filing of an.'Environmental Impact Reportunder MEPA? Yes 0 No'X REQUIRED 1URISDECTI.QNAL,DETERMWAV N FILING MATER4ALS Completed Regulatory Agreement Application SIGN147 i1R)r The undersigned intends to flI gul ry Agreement Application.with the Planning Board of the Town of Barnstable for a'Regulat ry,Agreement/ the manner and for the reasons set forth above: S:i.gnature: r. _ Apphrit(s) APP #' sentative Print: ;D:avid4t. LawlerEs wr Signed by ❑Applica plicant's Rep.resentati e Date: r Ma:iljng Address of ::pplicant(s) or Applicant s Representati.ve 540 Main Street,_ ite&banns, MA 02601: Email Address:of Applicant(s)-of Applicant's Representative dlavvler:ggy_@verizQn_:net 3 - I NEGATIVE DETERMINATION WHEREAS;the'Cape Cod Commission:has reviewed the project at 1.15 Main Street, Hyannis.,Massachusetts by-the Applicant, Cape Cod Recovery,LLC, which is requesting a Regulatory Agreement by the Town Cotuicil for the Town of Barnstable; WHEREAS,the Project.is in.the Medical Services District of the G'rowih Incentive.Zone as adapted by the BarnStabte County Qrdinance 2'00&K,and WH.EREAS;.the thresholds:und:er.said.ordinance have.vet ao...:be met, THER.EFGRE, it is determined that hi project i5 I.not.subject to.the juri diction of the Cape Cod Gon=ission zmd as such a i egatiwe determination is'rendercd on said Ptoj:ect. Cape Cod.Commission _.._......._......_____.__.._�_ By Its':Authorized Representative Town of Barnstable Planning Board -----Applicationfor a Regulatory Agreement_._ (Attach additional sheets if necessary) A regulatory agreement is a contract between the applicant and the Town of Barnstable, under which the applicant may agree to contribute public capital facilities to serve the proposed development and the municipality or both, to build fair affordable housing, to dedicate or reserve land for open-space community facilities or recreational use, or to contribute funds for any of these purposes. The regulatory agreement shall establish the permitted uses, densities, and traffic within the development, the duration of the agreement, and any other terms or conditions mutually agreed upon between the applicant and the Town. A regulatory agreement shall vest land use development rights in the property for the duration of the agreement, and such rights shall not be subject to subsequent changes in local development ordinances. For office use only: RA# The undersigned hereby applies to the Planning Board of the Town of Barnstable for a Regulatory Agreement, in the manner and for the reasons set forth below: 1. Applicant Name4: Cape Cod Recovery, LLC Phone: 508-778-0303 Applicant Address: 115 Main Street, Hyannis, MA 02601 Applicant Email Address:d lawler.atty(a)_verizon.net 2. Project Name: 115 Main Street protect Property Location: 115 Main Street, Hyannis; MA 02601 If applicant differs from owner, state nature of interest:5 The applicant is the nominee of buyer under an executed purchase and sales agreement 3. Owner(s) of Record. Provide the following information for all involved parcels (attach additional sheets if necessary): Owners Land Ct. Lot& Registry of Deeds #Years Map/Parcel Name Certif. of Title# Plan Book/Page# Owned 327/202 Piscano, Margo 27249/288 3 Page 1 4 The Applicant Name will be the entity in whose name the Regulatory Agreement will be executed. 5 If the applicant differs from owner,the applicant is required to submit one original notarized letter authorizing the application,a copy of an executed purchase&sales agreement or lease,or other documents to prove standing and interest in the property. Owners Contact information (�d��ran tfn�mopp|ioan� ` ' Name Address Pisoono. K8oqJo 73 Harbor Bluff Road, Hyannio, MA 02601 508-428-4443 margo@mapgonals.com ' 4. List all Zoning within which the property hslocated: 5. |o this project located within the Groundwater Protection Overlay District? Yes [Xl No l O. Is this project located within the Hyannis Maim Street Waterfront Historic District? Yoe [ ] No [X] ' ' 7. Does this project involve the demolition or alteration of a building or structure or any portion of any building or structure, that ks over 7S years old? Yea [ ] No[X] 8. |a this proposal subject bothe jurisdiction of the Conservation Commission? Yes [ l No[){] || 9. | �h�p subject bo the jurisdiction of the Board ofHealth? Ymn [ ] NoCX] � 10. Is the Cape Cod Commission a party to the proposed Regulatory Agreement? Yes [ } No 11. Total land area subject ho the Regulatory Agreement: Total land area Uplan land area wetland: 12. Total estimated cost of construction: 13. Existing Development—Describe existing buildings including number of buildings, Gross Floor Area of each building, height of each building and uses in each building (include Gross Floor Area of each use): The structure was originalIV built in 1820 and consists of two stories wood shingled structure with gable/hip roof, seven bedrooms, five baths and eleven rooms total-2,436 feet of living area 14. Existing F eysidenUa| Uses: Provide existing density (units per aure). number of total residential undo. � number of market rate units, number of affordable units'counted in the Town's DHCD inventory, and number of � � workforce units deed restricted., together with the number of bedrooms contained in each unit(also identified by � market, affordable and workforce), and a description of which building said units are located (if more than one residential building exists on site): 7 bedroom house 16 General Description of proposed agreement: The proposed Regulatory Agreement is for a change of use in the Medical Services District which does not allow for overniqht stays, the overnight treatment facility may also require density relief See Attachment / � | _ Proposed Level Vf Development' Number of Buildings: 1}____ . | PnoposedUsa(s):Density of Proposed Uses: 7 bedrooms-up to 18 overnight patient stays Height of Proposed Uses: - Same two stories | | / � � 16. List all zoning relief sought under the regulatory agreement, including a reference to each section of the zoning ordinance under which the applicant seeks relief. (Note: This information will form the basis of the legal advertisement for public hearings on this application and should include all relief that may be required to construct the project. Failure.to list all required relief may result in an inability to approve the application and may result in the need to re-advertise the public hearing(s) on the application.): Use and Density as applicable for the NIS Services District 17. List all relief sought from general ordinances, rules and/or regulations of the Town of Barnstable, including a reference to each section under which the applicant seeks relief(Note: This information may form the basis of the legal advertisement for public hearings on this application and should include all relief1hat may be required to construct the project. Failure to list all required relief may result in an inability to approve the application and may result in the need to re-advertise the public hearing(s) on the application.). Chapter 59 comprehensive occupancy seeking 18 people in 7 bedrooms-Ordinance allows 9 18. List the state and/or Federal Agencies from which permits, funding, or other actions have been/will be sought: Not applicable 19. Proposed duration of the Regulatory Agreement(Note: By law, the agreement cannot exceed 10 years. The duration of the agreement limits the amount of time during'which the applicant may seek to obtain development permits to construct the development. All conditions and terms of an executed agreement are on- going obligations of the parties that shall be honored in perpetuity once the applicant exercises development rights under the Regulatory Agreement): 10 years 20. A description of the public facilities and infrastructure to service the development, including whom shall provide such facilities and infrastructure, the date any new facilities will be constructed, a schedule and a commitment by the party providing such facilities and infrastructure to ensure public facilities adequate to serve the development are available concurrent with the impacts of the development: None 21. A description of any reservation or dedication of land for public purposes: Not applicable 22. Description of Construction Activity (if applicable), including any demolition, alteration or rehabilitation of existing buildings and a description of building(s) to be demolished, altered or rehabilitated: None Attach additional sheet if necessary J i Submission Requirements: The following information must be submitted with the application at the time of filing, failure to do so may result in a denial of your request. Plan Submissions:All plans submitted with an application shall comply with the requirements of Section 240- 102 of the Zoning Ordinance. In addition, the following shall be provided: • Three (3) copies of the completed application form, each with original signatures. • Three (3) copies of a'wet sealed' certified property survey (plot plan) and three (3) reduced copies (8 1/2"x 11" or 11°x 17") showing the dimensions of the land, all wetlands, water bodies, surrounding roadways and the location of the existing improvements on the land. • Four(4)copies of a proposed site improvement plan and building elevations and layout as may be required plus three (3) reduced copies(8 1/2"x 11"or 11"x 17") of each drawing. These plans must show the exact location of all proposed improvements and alterations on the land and to the structures. In addition, pdF electronic copies of all plans and materials are requested'as well as all an electronic file of all plans(format AutoCad.dwg, AutoCad.dxo. Electronic and pdfs can be submitted by disk or e-mailed to karen.herrand@town.banstable.ma.us. Other required submissions: • Review Fee(s) payable by certified check to the Town of Barnstable. • Deed(s)or Purchase and Sale Agreement(s)for all involved parcels.. • Proof of filing of a Project Notification Form with the Massachusetts Historical Commission if the project is located outside of the Hyannis Main Street W rfront Historic District. Other: The applicant may submit additional supp ing d uments to assist the Board in making its determination. All supporting documen`must b sub i d eight days prior to the public hearing for distribution to the Board. f - Signature: ) Date: Applicap(t's or Represe e' ature A44� Print Name David V. Lawler , Representative's 540 Main St., dite 8 H nnis MA 02601 Phone: 508-778-0303 Address: Fax No.: 508-778-4600 Representative's E-Mail Address: dlawler.atty(aD-verizon.net 6 Note: All correspondence on this application will be processed through the Representative named at that address and phone number provided. Except for Attorneys, if the Representative differs from the Applicant/Owner,a letter authorizing the Representative to act on behalf of the Applicant/Owner shall be required. I ATTACHMENT The Applicant seeks a Regulatory Agreement for use of an existing structure at 115 Main Street, Hyannis. The Applicant is not seeking to do any construction work or-lands caping work-ontlieproperty oth er- an rep anting grass see , fertilizing,trimming and otherwise re-invigorating the landscape presently on the property including laying new gravel in the existing lot. The Regulatory Agreement being sought is for use and density under Medical Service District 240-24.1.4 MS Medical Services District-Density requirements and relief from comprehensive occupancy under Chapter 59 of the Barnstable By-Laws. The use proposed by the Applicant is for an overnight treatment facility,a clinic which is generally permissible in the MS District but for the Applicant's request for overnight stays which is prohibited under Section 40-24.1.12.. It is further submitted that approval of the requested relief would be consistent with both the United States Federal and Massachusetts State Law - concerning the civil rights of the handicapped for whom this project is designed to serve. The property,which had previously been used as a boarding house,is presently used as a residence. It has 7 bedrooms and the Applicant proposes that up to 18 patients be authorized to stay overnight at the facility, 2 to 3 clients in each bedroom, depending on the size of the bedroom. The purpose of the,facility is to provide overnight treatment for clients,who are individuals addicted to drugs and/or alcohol,such individuals are deemed handicapped under state and Federal law and are due reasonable accommodations under the law. The Applicantwill provide 24-hour around the clock coverage to these individuals,who are not permitted to leave the facility unsupervised. The individuals will receive 6-day a week treatment at a separate facility where they will be transported in a supervised capacity each day. At no time are clients allowed to be in the community unsupervised. The anticipated daily treatment plan at the outside facility will include various counseling sessions, on both a group and individual basis in addition to other treatments geared to treating addiction. Upon a client's return to the proposed overnight treatment facility,the individuals are required to maintain the premises, cook their own meals and-otherwise interact with fellow housemates. .Training in these domestic skills is an integral part of treatment and is necessary for these individuals to become well and stay well in the long term The program ranges from a 30 to 90 day treatment periods. The principal of the Applicant is experienced in the addicted treatment business. This is a for-profit business and the property will continue to pay real estate taxes and under the present model,the facility does not accept Medicare and Medicaid but rather receives payment through private insurance and/or direct payment by patients or their families. The Application has been sponsored by Councilor James Tinsley who is the Councilor for the East end of Hyannis including 115 Main Street. The use itself is desperately needed both locally and nationally. There exists a substantial and horrific opiate addiction crisis in seasonally rural areas such as Cape Cod,the consequence as a result of this crisis is that facilities are desperately needed and the proposed Application provides for needed services,which do not negatively impact the area for the reasons stated above. A pP'fi " - :.;� .4.gF-•.o'er'- �, - - -- . .. - 'L -♦ •5 `l v .�' �r g , '•rFre'. ^t�g�e'1.L�1;,Ls - _ _. . - - ,Th.�.'�_�\'�'- 'Sh.' tr. -!e Y,` �• - _ . - a, oFWE T Town of Barnstable Regulatory Services 9B"x`',`, ' Richard V. Scali, Interim Director s63q. �0 039 ' Building Division Thomas Perry, CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 March 18, 2014 Margo Pisacano 73 Harbor Bluff rd. Hyannis,MA 02601 Dear Margo, It has come to our attention that the barn at 115 Main st. Hyannis has reached the point of being a potential hazard. This structure must be secured and made safe. Please contact me at the building department(508-862-4035) as soon as possible with regards to obtaining a pemit for this work. Thank you for your prompt attention to this matter. Sincerely, Patrick Franey Local Inspector Viz: � p Message Page 1 of 2 Anderson, Robin To: Polly Spence Subject: RE: Question about allowable use Hi Polly, The property you referenced appears to be in the MS zone and that district does allow for medical/dental clinics as well as professional office uses as a matter of right. I am not sure what the current of that property currently is but you should prepare your client to anticipate seeking site plan review approval in order to establish the intended change of use. As a result of that process,there may be site improvements necessary to officially convert the use(i.e.parking,landscaping,handicapped access and the like)and your client should be made aware of this aspect as well. Please let me know if you require additional information or clarification. pltgbin Robin C.Anderson Zoning Enforcement Officer 200 Main Street Hyannis,MA 026oi 508-862-4027 -----Original Message----- From: Polly Spence [mai Ito:PSpence@robertpaul.com] Sent: Wednesday, April 06, 2016 3:25 PM To: Anderson, Robin Subject: Question about allowable use Hi Robin, I have a client interested in opening a medical doctors office at 115 Main Street in Hyannis. Is this allowed at the property? I believe there are also two small rental units as well as a large "doctor suite". Would those be legally allowed? Thank you, Polly POCCy Spence Robert Paul Properties Cell:(508)942-1016 Fax: (508) 362-1424 www.robertpaul.com 4/7/2016 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map., 3 2 7 Parcel .2,O Z Application # ) S 1 Health Division Date Issued L 3 Conservation Division Application F AT 114 1)11m�_ Planning Dept. Permit Fee -31 Date Definitive Plan Approved by Planning Board _ 3 Historic - OKH1- Preservation / Hyannis Project Street Address IVA l/V 5' Village pr� A.A I'/� Owner /`7i¢1� r✓O Address Telephone -72 4� VYe:�� Permit Request ��J �om s�iii✓�' c= c^ L am= 571Z21--✓ o Square feet: 1 st floor: existing proposed 2nd floor: existing prop d Totagew Zoning Distri Flood Plain Groundwater OverlayME?5- w Project Valuatio BAc__-_Gonstruction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attac supporg dc(n &Umentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) `AJ n Age of Existing Structure lea-;4 Historic House: Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: Jd Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) s7_ Number of Baths: Full: existing new Half: existing new Number of Bedrooms: 7 existing _new Total Room Count (not including baths): existing 1_new First Floor Room Count .5'+ Heat Type and Fuel: �d Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes TZ�No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use �G=S%�G %l i G' - Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name � �. 6� •✓© Telephone Number _455 9 cf_I 4� Address l License # L7 5 Y6 2 Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE FOR OFFICIAL USE ONLY t APPLICATION# e DATE ISSUED MAP/PARCEL NO. I E ADDRESS VILLAGE OWNER DATE OF INSPECTION: s.—,FOUN-DATION., FRAME ' INSULATION S FIREPLACE s 3 ` ELECTRICAL: ROUGH FINAL _ PLUMBING: ROUGH , FINAL GAS: ROUGH FINAL FINAL BUILDING r DATE CLOSED OUT . 41 ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 600 Washington Street r Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information / ) Please Print Legibly Name(Business/Organization/Individual): Address: / , , /2 (o ' City/State/Zip: 111 ve5 �2.� Are you an employer?Ched the appropriate box: Type of project(required): 1 ❑ I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. New construction 2.�q I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me m any capacity. employees and have workers' 9. ❑Building addition [No workers' comp. insurance comp. insurance.t required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their l 1.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.�oof repairs insurance.required.]t c. 152, §1(4),and we have no employees. [No workers' 13:❑ Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copyof this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby ce under the pains ak#71des of perjury that the information provided above is true and correct Si afore: ��� Date: Phone#: 7 7 l el,2!�-A Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other � Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other,legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives;of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." . Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to-contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: Tl e,Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Bost n MA 02111 Tel.#617-727-4900 ext 406 or,1-877-MASSAFE Fax#617-727=7749 Revised 4-24-07 — - www,inass.goV%dia Town of Barnstable o� *, Regulatory Services i r RiRN�R'ARf.R t MASs Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner . 200 Main Street,Hyannis,MA 02601 ivww.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder e-�r-Y'4� Owner of the subject ro � J P PAY hereby authorize �ln -�C-S / -1��G/��0 to act on my beha}f, in all matters relative to work authorized by this building permit (Address of Job) Pool fences and alarms are the responsibility of the applicant. Pools are not to. be filled or utilized before fence is installed and all final inspections are performed and accepted. Sipatare of Owner Signature of Applicant Print Name Print Name Date Q:F0RMS:0WNERPERMISSI0NP0OL4 62012 I MP't Town of Barnstable '$� `�,,J}` -7 N;r` `'' Growth Management Department Hyannis Main Street Waterfront Historic District Commission wwrw,town,bamstable.ma,us✓hyannismainstreet Decision-Certificate of Appropriateness 115 Main Street—Roof,Windows, Doors, Siding, Painting The Hyannis Main Street Waterfront Historic District Commission,pursuant to the Code of the Town of Barnstable Chapter 112,Historic Properties,Article III,Hyannis Main Street Waterfront Historic District,:hereby approves a Certificate of Appropriateness for the following property: Property Address: 115 Main Street,Hyannis Assessor's Map/Parcel: 327 202 At the May 1, 2013 hearing, after consideration of the testimony given and materials submitted by the applicant and members of the public,the Commission found the proposal to replace the roof, replace and re-size four (4) windows, replace two(2)doors,repaint the front,re-shingle the side and rear will not.detract from the historic character of the.Hyannis Main Street Waterfront Historic District.The Commission considered the proposed window materials and color,the location of the structure, and past alterations made to the main structure on the property and found the proposed repair and replacement to be appropriate for the protection and preservation of the district. Based on these findings,the Commission voted to grant the certificate of appropriateness subject to the following.conditions: 1. Roof:Remove existing two(2)layers of asphalt roof shingles;repair framing&sheathing and re-roof with three-tab asphalt or architectural grade 2. Exterior Siding:Remove existing shingles;make any necessary framing.and sheathing repairs and re-side with- white cedar shingles which may be.painted white(front)or left to weather naturally(side&rear) 3. Windows:Remove four(4)existing wood frame windows and replace:with vinyl,energy efficient replacement windows in a smaller(shorter)size and in comparable area 4. Doors:Remove two(2)wood entry doors and replace with fiberglass,energy efficient entry doors to be painted white of equal size. 5.. Permits from the Building Division:are required priorto.commencing work. Present and voting in the affirmative to grant the certificate of appropriateness were: George.Jessop, Paul Arnold, Marina Atsalis,David Colombo, Iiam Cronin,Joe Cotellessa,'MeaghannKermey and Brenda Mazzeo c George Jessop jr.,Chai a \ Date Hyannis Main Street Tate t His is District Commission cc: Charles.Pisacano,Applicant' Tom Perry,Building Commissioner I,Linda Hutchenrider,Clerk of the Town of Barnstable,Barnstable County,Massachusetts,herevy certify.that twenty(20)'days have elapsed ince the Hyannis Main Street Waterfront Historic District Commission filed this. decision and.that no appeal of tt-decision ha�been filed in the office of the Town Clerk. Signed and sealed this. day of; 0A, /u fder -pains d enalties of:peIryy rju mda Hutchennder,Town Clerk f 1 g ..a Town of 'Barnstable Hyannis Main Street Waterfront Historic District COMITIission Application Certificate of Appropriateness Application is hereby made for the issuance of a Certificate of Appropriateness under M.G.L.Chapter 40C,The Historic Districts Act for proposed work as descnIM below and on plans,drawings or photographs.accompanying this application for. Assessoe's M2P NO. Z� . Parcel No. 2 -- Address of Proposed Work Applicant Name Applicant Mailing Address _ i3 z G TowmlStateop, Applicant Phone Number O X 7 7 ep- Applicant E-Mail �- •2 �' r'�G Property Owner Name owl'� 514c 14 r•�r� S i `-r c= Town/StateMp S Ifr� Owner Mailing Address �'r Owner Phone Agent or contractor!dame '/•¢ L�s � `"�-�",� L? Agent or Contracbr Address i f r-t Town/State0l) 5112' Agent or Contractor Phone G'��-' /� '7 Agent or Contractor E-Mail PROPOSED WORK Please check all categories that apply: Building Type: [] Commercial 1 Residential ❑Accessory ❑ Other Work Proposed: 1. Building Construction: D New Building ❑Addition Alteration 2. Exterior Alteration: R Windows [ Doors Siding SRoof i} (Q other 3. Exterior-Painting: 4: Signs: 0 New sign ❑ Alteration to existing sign 5. .Accessory Improvement:. ❑. Fence Panting Lot ❑ Outdoor Dining [] Awning/Canopy 6. Other. i Page 1 of 3 i (I i Hyannis Main Street Waterfront Historic District commission BUILDING MATERIAL SPECIFICATION SHEET Please complete this sheet only if new building.construction.or alterations to an existing building are proposed. Fill out all sections that are applicable to your project Include materials,specifications,dimensions and/or colors to be used. FOUNDATION SIDING TYPE S`t 1 ivy �L =� COLOR CHIMNEY TYPE COLOR ROOF MATERIAL. ROOF PITCH d DOORS COLOR W k / LCE COLOR WINDOWS SHUTTERS DOLOR COLOR TRIM �. } GUTTERS b PATIOIPORCHIDECK GARAGE;DOORS - COLOR - - i OTHER Page 2 of 3 i r Hyannis Main Street Waterfront Historic District.Commission DETAILED DESCRIPTION OF PROPOSED WORK Provide detailed specifications of the proposal. • Include a detailed description of changes to e)asfmg conditions,if applicable. • Describe proposed materials to be used,desired Mors,manufacturer's specifications,etc. • in the case of signs,give locations of existing signs and proposed locations of new signs. Attach an additional sheet,'rf necessary. J ♦♦+�' , `a 5'., c e�i///cif yY' / ♦ 19 T d ,1 G v/ T- 've- �cJ ♦ % U� ivy/ �' .ct sll� T �"/�/♦v'T ,r��/�%/✓ �es�CJ. c'-= s'F7/�G�"�..t�/:ty/a !�5' �it'/S" Signed. 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N��eg Permit Request 1� Ir©4x5-4 /3 /9-a/t/ Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 614,e' Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) A Age of Existing Structure Historic House: ❑Yes ❑ No On Old King s Highway ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sgl.ft) = Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new r Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing` ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name l�/l/ i��C� Telephone Number s`eF 2 2� r +_ Address l x02lp License # e::22,9� 2 -3 ,3 s Home Improvement Contractor# Email lii°. �® L=� �: �a Worker's Compensation # I � ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO `SIGNATURE DATE i ` : n - FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED k r � MAP PARCEL NO. i ADDRESS VILLAGE OWNER r , ,s DATE OF INSPECTION: I . FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ter.- FINAL BUILDING DAT-ENCLOSED OUT , AS$O Q-;.�`=ION PLAN NO. r - Department of IndustrialAccidents Office of Investigations ' 600 Washington Street Boston,MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/EIectricians/Plumbers Applicant Information Please Print Lepibly Name(Business/Organization/IndMdual): -zG== Address: CV z 6y7 g City/State/Zip: Phone#: Are you an employer?Check the appropri to box: Type of project(required): 1.❑ I am a employer with 4. I am a general contractor and I 6. ❑New construction - employees(full and/or part-time).* have hired the sub-contractors 2.;4 I am asole proprietor or partner- listed on the attached sheet 7. ❑Remodeling ----_—.__--ship-and have.no-employ These sub-coees---------_. ntractors have _ 8. ❑Demolition_ —• _ — working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers'comp. insurance comp•i sura ce 1 required.] 5. We area corporation and its 10.❑Electrical repairs or additions "affirm homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself [No workers'comp. right of exemption,per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees,[No workers' 13.0 Other comp.insurance required.] *Any.applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then him outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: ' Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK-ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and enables of perjury that the information provided above is true and correct Signature ` Date:O. /-' Phone#: Vl`� o -7 7 Official use only. Do not write in this areg to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town CIerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: orma on ana-AIDUStracnow Massachusetts General Laws chapter 152 requires all-employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,,corporation or other legal entity,or any two or more of the foregoing engaged in*a joint enterprise,and includi*the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,.MGL.chapter 152, §25C( )states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants PIease fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships (LLP)with no employees other than the members or partners,are not required to cant'workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents..Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call.the Department at the number listed below. Self-insured companies should enter their self insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/licease applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (Le.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would lice to thank you in advance for your cooperation and should you have any questions.- please do not hesitate to give us a call _ The Department's address,telephone and fax number. The Commonwealth of Massachusetts Department of Industrial Accidents Office of kvesiagations 600 Washington Suet. Boston.,MA 02111 Tf,-I,#617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 . Fax#617-727-7749. wwwxam.gov/dia � ETti Town of Barnstable Regulatory Services 9KAS& � Richard V.Scali,Director 'DTE039. Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I �O C5!�M/7 Q , as Owner of the subject property hereby authorize �j�L l t�� ��� to act on my behalf, in all matters relative to work authorized by this building permit application for: Gnoo Address of Job **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature if Owner Signature 6f Applicant Print Nam Print Name GC Date Q:FORMS:O WNERPERMISSIONPOOLS Town of Barnstable Regulatory Services mE roiy,4 Richard V.Scali,Director Building Division * RARN STD Tom Perry,Building Commissioner Mass. g' �659 m 200 Main Street, H annis MA 02601 � • Hyannis, 'DrEO �t a www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAlLrNG ADDRFSS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner" shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. _ The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules &Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems, particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit fbrms\EXPRESS,doc Revised 061313 Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supen'iso.r License: CS-086733 CHARLBS PISAC kN PO BOX 126 I 02 47 HyA" S POR I'MA Expiration 07/2912015 Commissioner s �P p N/ 'D JUN 1 S 2014 01-um-0 77Town of Barnstable tI�G L NirOld King'sHighway Committeeaamam Town of Barnstable Hyannis Main Street Waterfront Historic District Commission Application Certificate of Nonapplicability Application is hereby made for the issuance of a certificate of nonapplicability under M.G.L.Chapter 40C,The Historic Districts Act for proposed work as described herein, Assessor's Map No. J Z 7 . Parcel No. �/Z 6� Z Address of Proposed Applicant Name !�r 5/Q�l(f Applicant Mailing Address 1.2 G Town/State/Zip / ii�r/��'� cp 26 y7 Applicant Phone Number, � © Applicant E-Mail L�ea-ez L 6, -5 .ma c . Property Owner Name Owner Mailing Address /3!/z 4- Town/State/Zip Owner Phone Agent or Contractor Name Agent or Contractor Address Town/State/Zip Agent or Contractor Phone Agent or Contractor E-Mail This application is for exemption of proposed exterior construction on the ground that: It will not be visible from any public way or does not involve any exterior architectural or site features. (OR) It is within a category declared entitled to exemption from review by the Commission. PROPOSED WORK: Describe the proposed work,along with the location of the proposed work relative to all public ways. Signature: Petitioner/Agent Date CC d To: PROVGD Hyannis Main Street Waterfront Historic District CoCotY#mission, From: Elizabeth Jenkins,Principal Planner JUN 1 $ 2014 Re: Exemption-115'Main,Street Town of Barnstable Qld King's Highway Committee The property at 115 Main Street is improved with a 2,564 square foot single-family dwelling; constructed in 1820. There is also a freestanding;accessory barn,which appears to have been built around the same time as the dwelling.- The applicant is seeking.anexemptionfrom obtaining a Certificate of Demolition under Section 112-30(D)-Limitations,exclusions;:and exemptions,,which.:states the Commission shall exclude from their purview"actions taken to meet requirements certified.by.a duly authorized public officer to be necessary forpublic safety.' On March 18 2014,the Building Division issueda letter to the'property.owner indicating that the condition of the barnhad become a potential hazard and'requesting demolition. According to the Building Inspector,the barnis structurally unsound; both gable ends have come off and a. portion of the roof has collapsed:%:By,the Building Division's estimation,the barnis an attractive nuisance and a dangerto.anyone who may enterthe building. The current owner acquired the property in 2013. In May 2013,the Commission issued a= Certificate of Appropriateness fora replacement roof,;siding,:windows and trim for the principal dwelling. I I ZNaKHJVNVW HIMOUD APPROVED — ��o� z � Nor JUiJ 18 .2014 � . Town of Barnstab wa.le - Q.Imaoaa: OfdKinOs!N oW'n: of.Barnstabt.e Hyannis Main Stre Het Waterfront Historic DistriCtr.Commission Application Certificate of Nonapplicability Application is hereby made for the issuance of a certificate of nonapplicabilityunder M.G,L::Chapter 40C'The Historic Districts Act- for proposed work as described herein: Assessor's Map No. , :.�> Z-7 Parcel No. /2:�- Z Address of Proposed o f/ � -� /� r4f�id�. Applicant Name p i Applicant Mailing Address � � ��1� � TownlState/Zi ��i►� -sl'©�� � Applicant Phone Number L5 Applicant E-Mail Property Owner Name Owner Mai ling Address Town/State/Zip Owner Phone c T—© Agent or Contractor Name Agent or Contractor Address Town/State/Zip Agent or Contractor.Phone Agent or Contractor E.Mail This application is for exemption of proposed exterior construction on the ground'that: E` It will not be visible from any public way or does not involve,any extenorrarchitectural or site features. (OR) ]� It is within a.category declared entitleflo exemption from review<by the Commission. /PROPOSED WORK: Describe the proposed work;along;with the.location of the-proposed work relative to'all public ways. Signature Petitioner/Agent Date: FARM B—BUILDING Assessor's-Number. USGS Quad Arm(s) Fonn Numba 71 MASSACHUSETTS HISTORICAL COMMISSION''- 3272d2 ny �58a 8Y15$5 MASSACHUSETTS ARCHIVES BUILDING 220 MORRISSEy BOULEVARD APPR !/ED Town: Bamstable BOSTON,MASSACHUSETTS 62125 Place:,(neighborhood or village) J U N 1'810i-4 Photo Hyannis re h._ Town of Barnstable i`w y 4 Address:` 115'Mai n Street Old King's Highway Committee Y � Historic,Name: :Lot Hallett House&`Bam Y.* W Uses: Present- MUM.Fatuity Residence , , r Original: single.Family Residence �. Date of Coustracdon: c. 1820 i.( Source: 196 MHC fomt Style/Form VictUdan Eclectic ZA Architect 000cr Unknown Exterior Material: -� Foundation: Concrete Wa1VI'r m: Wood Clapboards Topographic or Assessoes'Map Roof: Asphalt Shingle' > am Odtbuildmgs/Sec±ondary,Structures:' ,p Bam' 0 It Major Alterations(with dates): Queen Anne&Colonigl Revlvai decorative elements.adde.d 3I77Pd _ (late 20`"cen) _ o f06 i '0i .a t n ro Store Demolished(after.1949). Replacement Windows(late 20'"cen) Condition:: Good y . 1 ' �... Acres e:, o x .41 es Date: >:> g-. 0,d4 Sctdng:" Located.on a relatively flat loton Main °'va 00 Street-on the edge of Park Square-.in an area chacacderked dee td et 0 +o,.,io p'" , � by:19 ,Century residences.and late 20. .century infill and .., ?? «m conversions. to commercial uses: Recorded by: .Julie Ann Lary;ttl-architects` Organization: Town of Barnstable Date(ntontDi/year): September 20.08` ---, ftlbft 0 DaftL � Foucnv u=aciwemw,aorkal Commission surwy'Mamral insvwio)is for complerfng.#&form INVENTORY FORM-D'CON'TINUATIOI1 SHEET BAItNSTABLE I15NiaiaStreet MASSACHUSI TTS HISTORICAL COMMISSION Area(s) Form No. 220 MORRLSSEY BOULCVARD,BOSTON;MA.S.SACM'jSerI 02125 FAU711584& 1585. AFF j, Recommended for[istrng,in the National egister.of Historic Places. !/ciier ker/ uvtr must riltach a ciuvnlelerJ'tVurinnrtl,ltctctc�i Grttrrta:.Stuf�murt form... . . _ LU IT Use as much space as necessary to complete'ihe following entries,allowing lea to flow onto additional continaation,&*4 n of Barnstable Old Kings Highway Committee ARCHITECTURAL DESCRIPTION Describe arc Reclura!feetraes Evd1date the characteristics ojthrs bu ldrrrg in`ternrs of other buildings within the community. The house at 115 Ualn Streetrlses.two'stories40 iii wide,aide-gable roof.It;is L-sMped in-plan formed by a nearly square house V&a long intersecting one-stb^ bled:,all on the rear,(east)facade.This eil.houses.two apartments. The main.entrance is located on;the'stde`(south)'faoade,which features a`six-sided'Cdlonial Revival porch with:an entablature supported by narrow Tuscan columns and'a simple balustrade.A'small.entrance block Projects underneath the porch with a wooden paneled entrance door..A two sided cant bay window"featuring a 20/1 sash windows Is asymmetrically located on the roof pf..me porch. The frbht.(westj fagade has a one=story bay AndoW oczi, on the northern bay of its three-bay.facade:This bay wintlow,has-a shed'roof;and;features a large:;fixed iightWindowwiffi4racery at the bop.A;shed roof dormer with:Wide 2/1 windows is also ocated'on,this fa�atle. , The no slde:facad6 featurbtla rnas'W'Vutside4nd brick'chMey,a fist-floor oriel vuindow,and�a small Queen Anne window. Fenestration,except where alteady noted,•includes 2/1;=l nand 1/1 sashes:The house'it cdad in wooden clapboards,and features cornice>retuniS and a narrow entablature at,the eaves. The,house shares its Plot;with a well preserved barn.tt nses.twb stdnes to a front gat�le,roof with a one-story shed roof ell The gabled section features cornice-retums,.simple entablature,and a:blocked diamond=shaped window.Large double shed doors are centered on the front(west)'facades of the..gabied section and the elL,Utiol the middle of the 2¢ury,the barn was connected to the'',house:wdh;a series of one=story.°outbuildings.., The House is located on a plot of;land bordered bji Park Street onthe west The house is set back a short distance from the street,and is Highly visible ohAts north,.south,and east facades.The barn is located southeast of the house.The iwo buildings are.an unusual total example of a we house and'barn in the.historic district Although altered'by late 19h and early 20'"century details,thet Ouse and-,barn together make a,0rl6ddrately,significahtdontilbution to the historic'district. AISTORICAL NARRATIVE Discuss thi-histoy.of the boilding. 'Fatplain its associations with local{or state)history. Include uses of the buddbW,and the roles)the ownersfoccupanu played Wthin•the community. The,area of Park Square was"kt'oum in-the 19'"centur Lot Hallett's comer.The house'at 116 Main Street was formerly 15 Park Street or Square(c1930-199ti) The house belonged to Lot Hallett in the second half of tt a nineteenth century Lot Hallett notes in-an 1899 deed that he acquired the property from•Eliza A Baker.The 1840 deed;between Lot Hallett and:Eliza Baker does not mention any dwelling:,It Ls likely that the house,.at 115 Main$treet:wa :built'ca.1:841 Lot Haitett had anumber of occupations including blacksmith,(1850 Census),livery stable;keeper(1860 Census);grocer(1870 Census);antl coal mercFiant(18$;0 Censu"s):He was barn'm Yarmouth in 1815 to.Lot Hallett Sr..and his w&.Sally.Lot Hallett Jr. married Elizabeth Sears in.1,847.They had several ch8dren including Frank(b: 1851).Frank acquires the housefrom Lot Jr.in 1'899'and is shown as thb,ownerin the.190TAtlas. Continuation sheet l INVENTORY FORM B CONTINUATION SHEET BARNmpu 113 Main;Street MASSACHUSETTSHiSTORICAL,COMMISSION Arp.gs) FormN% 220 MORwssc-y Bout:rvARD,BosTON,MAssACHushTrs 02125 AU 1115.84& 15.85 APPROVED Additional owners include Agnes Boyd:'(1971-1'090);and Glenn Laroche 09W,2008). BIBLIOGRAPHY and/or REFERENCES JUN 18 20W Tow Barn able Hartmann,Lisa. 15 Park Street Massachusetts Historical Commission Inventory-Form;S.Bamstable:Bamst j°I way Commission;1,996. Committee Town of Barnstable.Assessors Records. . 1880'Map of Barnstable. Published by G.H. Walker&Co.With.inset details of Hyannis Village. available-on line at historicma wo orks 1905 Map of Bamstable. Published by.Walker IJthograph an4 Publishing Company,. With inset details of Hyannis Villa9e. available online-at't abricmay-wo*9 1910 Map of Barnstable. Published by Walker:Lithogra,ph and Publishing Company. W,ith inset details of Hyannis Village.avAilable online at°historicM0 wp *s. Sanbom Fire Insurance.Naps. May 1901; January" 1906 September`1912; September 1919;_November 1924; October 1932; 1949. available online at sanborn.urn con' Continuation:4heei,2 MASSACHUSETTS HISTORICAL COMMISSION Tewksbtn 115 Main Street MASSACRUSETTS ARCHIVES BUILDING..' 220 Moiddss9Y BouLEVAIi>D BOSPON9 MASSACF{uSkws 02125; Area(,) Form No.AU 115841585 APPROVED `1ROBED JUN 18 2014 Town of Barnstable NAtional Register of'HiStoric Places Criteria Statement Form. Old Committee way C.h&k Al that apply::. ® :Individually eligible ❑ Eligible'only in-a-historic district. ❑'Contributing t0l a;potential historic district 0,Potential,historic district Criteria: is -A B ® .C Q D. Criteria Considerations: 0 A ❑ 2 ,D C .0 D [I E [3 F ❑ G Statemen0f,Significance by Julie Ann'Larry.ttl-architects, -The criteria thatare checked in the,above sections must be just f ed here.: The Lot illett`House&Barn would,be individually eligible.for.lis6ng on the National Register of Historic Places under Criteria C as an intact representative example.of a TO residence and associated outbuilding;:and under Criteria A for its local signMicance,to'eastem Main,,Street's residential 190 century,history:The two buildings,are an unusual local example of house and a weWpreserved barn.Although.altered by latie 10 and early 20�'century details,the house and barn together are"a:good local example of Hyannis 1-9' eentury"residential architecture. FORM B—BUILDING Assessor's Number Area(s) rm N 6 .327I202 Hyannis �t I 1, 11 r (c� # MASSACHUSETTS HISTORICAL COMMISSIONP. MASSACHUSETTS ARCHIVES.BUtLDING Town Barnstable 220.MORRISSEY BOULEVARD BOSTON,MASSACHUSETTS 02125 Place (neigl;borliood/village) Hyannis jUN I $'2014 l Town of Barnstable ON, • - - '.• - . 9 ,,,. ' � ,�>x;♦ ame L.Hal,lettHouse S< C f JS • r k.Residential al Residential �.: traction;ca. 1820 . _ ( _ Assessors record Federal,Queen Anne,Colonial Rev.. udder Unknown -a. terial;. T _ - Concrete bundings-betuteen inventoried buitding anTn0aares +t-►'Terser- Wall Trim Wooden clapboard,wooden slrintzle;wood tion or natural feature.`Label streets.including,route numbers; 'if any: Circle and number the,inventoried building. Indicate north. 'Roof As6halt shingle o t.,l l,, } OuthuRdings/Secondary Structures,Barn Major Alterations:(with:,dates) t?ueenAnnearil •r 0 Colonial Revival decorative elements added(late 20th c.)• one-st(iry rear;ell,(ca. 1965) Condition Good Moved°' RID, `l]yes Date Acreage, AVacrc Recorded by Lisa Hartmann Setting :Located in an area-with'nesidences and office Organization Barnstable Historical:Commission buildiots(most converted from residences) ;.Pate;Onontlr/year) June 1996 Follow Massachusetts.liistarical Commission Survey Manual instructions/or,completing this_form. BUILDING FOR10/i. s ARCHITECTURAL DESCRIPTION see continuation sheet; Describe aPghit chiral eatures. ErmHiatE thee charactnutics of.,this 6uilding,.in,terms.of.other buildings within the community. f. The L:Hallett House.:rises two stories to a,wde side=gable1. roof.Itis L-shaped.in plun.fomiedby a nearly , 1 square housewith a-'long intersecting;'one-story,gabled�ell on the.rear.(east):facade-.This.ell houses.two 5'� apartfnents. h The.main entrance is located on the side(south)facade;which`features a six=Sided Colonial Ravival pore 9� �� , with:an entablat iiure siSpported..by.nan Tuscan columns and;a simple balustfade:-A small entrance block projects underneath the porch with a wooden`.p'aneled;entrance door.Alwasided cant bay.Window SUN• 8 2014 featuring.a 20/l sash,is.asymmetrically-located on the roof of the.porch. TO*n of narnsrC&t iR The;front(west)-facade has a-one=story,bay window 1.0, ed'on the northern bay of its`three=bay facade. Old K;n9•$H;yrrw•y This-bay window has a.shed-roof,and features a large•fixed light window with tracery at the top.Ashed mittee Com roof dormer with wide`2/1 windows,s also located on"this facade.. The=north side facade'features a massive outside end.brick chimney,afirst=floor oriel,Window,and a small Queen Anne window: HISTORICAL NARRATIVE' asee continuation.sheet Discuss the history,of the buildings Explain its associations wuth lonl (ors"fate) History. MCI uses of fhe.building, and the roli(O,fhe�owners/oceit ots.plgyed within, the.•comIn inity. Maps indicate that the L:Hallett House was in the Hallettfart►ily until.at least the.beginning of the 20th century:Constntctetl,in ca 1820,`the house is located in an.early Hy annis-residential neighborhood located on the fareastem part•of 1Vlain'Sticet.During.the'second part of the 2t)th century,many of the houses in this-area were-convected to commercial use as office space:Th'e house at 15 Park Street retains its residential use:,, l _ , BIBLIOG.ItAPHY andJor ItEFERENdt see continuation sheet'' Atlases%Maps:: Sanbom;,Maps. 1932,1949. Walker;a eorge H &Co Atlas of Barnstable County. 1880: . Walker Lithograph Co.Atlas of Barnstable County: 190Ti' Wailing,Henry.F Atlas.of the.Counties of Barnstable,Dukes and Nantucket. 1852. ❑Rernmmended for listing in the National Register,of Historic Places.If,checked,you cmust attach a completed.National Register Criteria Statement`_form.;: 1/95 INVENTORY FORM CONTINUATIONSHEET. Town Property Address MASSACHUSETTS HISTORICAL COMMISSION. Barnstable. 15 Park'St, MASSACHUSETTS ARCHIVES"BUILDING, 220 MORRISSEY BOULEVARD Area s Form N_um�r BOSTON,MASSACHUSETTS 02125 ARCHITECTURAL .D.ESCRIPTION (cont.)> A P P R V EM Fenestration,except where already noted,includes?J1,.2 wooden cla /2,and 1/1-sashes.The house is clad.in pboards,and features cornice returns-and.a narrow;entablature at the.eaves. JUN I.8204: 77re house spates its lot with a welt;preserved barn;It rises two stories to. front-ga61e roof with a Ord n-aKin s f tigt,wa p Town.of 8drnstaojE. one-story. shed roof ell.The gabled section features comice.retums;simple entablature,and a blocked e y diamond-shaped window,barge double slied'doors are centered on the front(west)facades of he gabled *9 section and the ell.Until the middle,of the 20tti century,the_;barn was.con"nected,to the=house with.: series of one-Story outbuildings. The L.Hallett House is located on a plot of land.Bordered by`Par](Stree t.on the west.:Thc house is set, back a short distance from the street,and is highly visi,ble,on.its north,.,:south,and east facades barn is located southeast of the house.71re:two buildings are an unusual example of .The house and bam in the historic district:The house,according:to the'AssessorsRecords,WAS constructed in ca.' 1820.It is an example of a simple Federal styleAiouse with later Qu,, -Anne.and Colonial Revival. updates.71ie house:and-barn together make an:important contribution to the historic.district.,, 1/95 MA§MtHUSETFS HtSTOWCAL CbMMMION Tewksbury: 115 Main Street MASSACHUSETrS ARCHIVES'BUILDING 220 WRRISSEY B61L1LEVARD` BOSTON,MASSACRUSEM 02125 Ara(s):. FormNo. - rU - 15841585 APPROVED JUN 18 f2 .4 Nsaional Register of Historic"Places Criteria Statement Form Town of Garmmzmie Old King's Hica'way Com►nittee Check all.that apply: ® Individually cligible. ❑, El'tgible.only in a historic district ❑`Contributing to A:potential historic district . . ❑,.Potent al'histo6c district 'Criteria: ® A Cl B. 0 'C ❑. D Criteiia.Considerations: ❑ ,A `❑ > _ ❑ C ❑ .D ❑: :E ❑ F" ❑ G Statement of Significance by Julie Ann.Larry,Al- chit . The criteria that are checked in the above:sectidns moat be jastified.here. The`Lot"Hallett House&Rath-,Would.be individually eligible foc listing on ahe National Resister of Historic Places under Criteria C as;an intact representative example.of a 19'residence and>associatcd outbuilding;and under Criteria A for its local stgnifeance to eastern'Main Streets residential'191°century history.,The two buildings are an:unusual local example of house and:awell-preserved barn.Attliough altered by'late 19�'and early 2(N°century details,the house and. barn together are a gbod Iocal example of Hyannis 19's century residential architecture, r Massachusetts Historical Commission Community Property Address 80 Boylston Street Barnstable 15 Park St.. Boston,Massachusetts 02116 Area(s) Form.No. AU- National:Register of.Historic Places Criteria Statement Form- APPROVECD Check all that apply: l9 Individually eligible- 0 Eligible in a historic,district: JUN 1-8 L 0 Contributing to a potential historic district Q'; Potential his, .,,trio. Town of BarnstaNe Old Kings.Hignway Commitiee Criteria: A O B; C 0 D Criteria Considerations: O A 0 B 0 C 0 D D E O F O G Statement of Significance by Candace Jenkins The criteria that are checked in the above sections must hued here. The L Hallett House at i5 Park Street;,in the Hyannis.Inner Harbor area possesses integrity of location, . design,setting(early-ZOth.century;partial);.materials,workmanship,feeling,and associations.Dating to ca. 1820,it is signif cant as one of the earliest surviving build* in.central Hyannis,:and one that embodies the residential aspect of the village's long and varied'history.Originating as A typical Cape Cod.cottage,it also displays a series of well-conceived changes,and additions tin the Queen Anne and. Colonial Revival styles.The most prominent of'those later features is:a verandah.Increasing-numbers of dwellings in this area have been converted:to commercial and.off ce use in recent use,a•trend that has not yet effected this property.The fine residential:character of the Hallett House is enhanced by retention of an end-gable barn.The'L Hallett House,thus,meets;cnteria.A-and C of the National Register Of`Historic Places:It is important on the:local level,with a_period of significance extending from its construction ca, 1820.to the present.: 7/92 I William Fitzgerald Master Plumbers lic ## 12912 have inspected the building "rear barn" located at 115 Main St Hyannis, and state that there are no gas or water lines in the building. 4/18/14 Sincerely 4 William Fitzgerald WRS Electrician Inc 110 Breeds Hill Rd—Unit#S Office Phone/Fax: 508 778 5936 Hyannis, MA 02601 E-mail:wrselectrician@comcast.net April 24,2014 To whom it may concern Ref.: 115 Main St., Hyannis, MA. I Wellington R. Soares,electrician, license number 21075A, 11376-8,am writing this letter to declare that the power to the garage located at 115 Main St, Hyannis, MA, is off. If you would like any further information regarding this subject you can contact me on my cellular phone 774 836 5877. Sincerely, Wellington R.Soares --' , TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION -iMtVISTARE Map �i Parcel 'L OFF Application # 0 5D Health Division Date Issued Conservation Division Application Fee Planning Dept. , .� Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address ��/ � Village Owner C`! -S l t5�i�4�s��`� Address Telephone S 7 7,a Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay " Project Valuation onstruction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure ld'®-/- Historic House: PrYes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full . ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new ' Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) _ Name ^--4D Telephone Number Address 7 License # d i Home Improvement Contractor# Email Cj� L�� �-r�/�/,/� -o�T/�s'�C�.y Worker's Compensation # ALL CONSTRUCTION DEBRIS �RESULTING FROM-T-HIIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 15Z FOR OFFICIAL USE ONLY APPLICATION# k ' DATE ISSUED' MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: ' FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING ` DATE CLOSED OUT ASSQ.CIATION PLAN NO. e, .axe Cortsl�r�rrtfc�of�ussacltrus Ue1wfnmt of fin rmft ial Accidents- 01TWe Offimat ga ions 600 Kwhingtom&reet Blostan,MA0211I wn'w.masmgoWdia Worket.-s' Compensation lummnce Affidavit:Bizilders/C:ontractorsf0ectricians/P'lumbers Applicant Infarmation Please Prnmf LegiMy Name 03� n; 'oaadividmO: �1 46rs 95 ,ca e-/4/LO Address_ e::5 4,946 City/Stat&Zip: Phonp-4-- 50W .77� Are you an employer. Check the ap:ropriate bo= Type of. 4. Iarna contractor and ���'_ 1[.❑ I am a employer with I project�r 6_ Nevv ioa employees{full and/or patt-fime}* have hired the sub-contr tors. Z_❑ I am a sore proprietor or partner- listed on the attached sheet. 7- ❑Remodeling ship and have no employees These sub-contractors have g- ❑Demnlifioa w for me in an capacity- �loyees and have workers' o�g Y � 9_ �Build-mg addition Lldo WOrkerS' comp_i+�� a comp_insurance repotted-] S.. We are a ccrporationand its 10_❑Electrical repairs or additions 3_❑ I am a homeowner doing all work officers have exercised their 1I_.0 Plumbing repairs or additions myself. [No workers'comp_ right of e2mmptio-a per MGL 12 Roof ;'nmtranre required] C c 1.5Z §1(4} and we have no employees_lido wor=s' 13_❑other comp_Insurance required-1; Arty appli om-t that checks boa W 1 amst also fill otzi the section below shau ina ibei r woffcesT coutgensaiioa policy ir rmatiari Homeawns3s what submit this a uda�it i„ ry they ace 3aing a1T t�udc and then late oniside ca�tracmrs psi scab® s aifid3rit hag sorb- C�ctors that c5eck this boz must sttached as additional sheet sboxing the name of the sob-ors mfl start±whether xnot those prjid s fixve zmployees. If the strFa-conti$cenrs hace employees,they nncst puvAe their workers'comp.policy numbez I am are empkyer that is pmidLV workers'compsrrsahon irmirance for my empTayeRr Heiotr is thepo&y an.d}ob site infortr;ahan< Insurance Company Name: Policy t#or Self-ins-Lim;k Expiration Date: Job Site-Adddess: City/StatelZrp: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coi-r-rage as regtsiredun&r Section 25A of MGL c. 152 can lead to the imposition ofcriminal penalties of a fine up to$1,500.00 and/or one year imprisonment,as well as civil penalties in$ie form of a STOP WORK ORDER-and a fine of up.to$250.0.0 a day against the violator_ Be advised that a copy of this statement may be forwarded to the Office,of Investigations of the DIA far ins ance cm-crage verification_ I der hereby cerftfy render the pains ant[penalties ofpedw y that the irzformtd&n pravi&d a bave is bwz and correct Sitmatam- 1�/� �yi Qi�.d Date- Phone# ll.ffkial use only. Ike not write in this area,to be completed by city or town of iciaL City or Town: PermitUcense# Issuing Aotherity(circle one): 1.Board of Health 2.Buil' Department I Cit:lITaw r Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: 6 e Information and. Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto this statute,an employee is defined as"_..every person in the service of another under any contract of hire, express or implied, oral or written_" An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer;or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shaII withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the common Wealth;or any applicant who has not produced acceptable evidence of compliance with the insurance.coverage required." Additionally, MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority_" Applicants — Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their cerhificafe(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(L LP)with no tmployees other than the members or partners,are not required to carry workers' compensation insurance_ If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit '11e affidavit should be returned to the city or town that the application for the permit or license is being requested;not the Deparlment of Industrial Accidents. Should you have any questions regarding the law or if you are required to ob'�in a workers' compensation policy,please call the Department at the number listed below. Self insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you retarding the applicant- Please be sure to fill in the permit/license number which will be used as a reference number. In add tics,an,applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations In (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses_ A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would Ile to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commaawcalth of Massachusetts Depaztcnent of Industdal Accidents Qfce of kvestigafioas 600 Washington Street Boston_MA 02111 Tel.4 617-727-4!M i xA 406 or I-$77 I A$SAFE Revised 4-24-07 Fax 9 617-727-7-749 www.zaas-s-gov/dia oF�� * saxxsrAE= • "'" Town of Barnstable ArED��p Regulatory Services Richard V.Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 5087-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder ,as Owner of the subject property hereby authorize � 1L= l��L� �t� to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner at Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. QAWPHLESTORMS\building permit fonns\EXPRESS.doc Revised 061313 License or registration valid for individul use only ar srt�crr�uorGLs t _ �� >tvrrur�uf�rtun•�zt(�ref. � before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation } _Office of Consumer Affairs&Business Regulation E { ME IMPROVEMENT CONTRACTOR Type 10 Park Plaza-Suite 5170 ' registration 179053 Individual Boston,MA 02116 xpi ration: 6117�120. CHARLES PISACANOI CHARLES PISACANO r g_- Lam' ' d without signature 73 HARBOR BLUFFS RD Not vali . i HYANNIS,•MA 02601 -' Undersecretary s . i Massachusetts-Department of Public Safety Board of Building Regulations and Standards Construction SupLrvisor -� License: CS-086733 CHARLES PISACAN01r� PO BOX 126 HYANNIS PORT41A D 7 Expiration .� ;• Commissioner 07/29/2015 r_ { 3 Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet(991M )of enclosed space. f Failure to possess a.current edition of the Massachusetts State Building Code is cause for revocation of this license. For DPS licensing information visit: www.Mass,Gov/DPS E N t '4CORp® CERTIFICATE OF �^*� ►LIABILITY INSURANCE 06/0412015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsements. PRODUCER Bridge Insurance Assoc. CONTACT 80 Langley Road PHONE (617)965-1777 1 FAX (617)964-1888 2nd Floor E MAa Newton Centre MA 02459 SURPRIS1 AFF r G C01/6tA NAIG p Commerce Insurance INSURED INS u John Brady -INSURERc 220 Castlewood Circle Hyannis MA 02601- IN su INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, S'ISR TYPE OF INSURANCE ADOL SUBR POLICY EFF POLICY EXP POLICY NUMBER LIMITS A X COMMERCIAL GENERAL uAwLry BGHWML /23/2014 6P23/2015 EACH OCCURRENCE $ 300,000 CLAIMS-MADE OCCUR DAMAGE TO RENTED $ 100,000 _ MEDEXP(Any one mon 5,000 PERSONAL S ADV INJURY 300,000 RGEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE POLICY PRO- LOC PRODUCTS-COMP/OP AGG $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO BODILY INJURY(Per perean) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per acddert) $ HIRED AUTOS NON-CANED AUTOS PROPERTY DAMAGE $ $ UN6tELLA LU18 OCCUR EACH OCCURRENCE $ [�EXCESSUIAB CLAIMS•MADE AGGREGATE $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS{.IABILliY UTE ANY PROPRIETORIPARTNERIE(ECUTIVE � E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N I A (Mandabuy In NH)M d= E.L.under DISEASE-EA EMPLOYEE 6 ,describe T E.L.DISEASE-POLjQYMMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks SchedWe,may be attached U more space is required) CERTIFICATE HOLDER CANCELLATION No holders SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WALL.BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATNE ©1988.2014 ACORD CORPORATION. AN rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD -Loop Up Print Page 1 of 3 ✓ Owner Information-Map/Block/Lot: 327/202/-Use Code: 1210 Owner Map/Block/Lot GIS MAPS 327/202/ LAROCHE,GLENN M Property Address Owner Name as of 1/1/12 15 PARK SQUARE 115 MAIN STREET(HYANNIS) HYANNIS, MA. 02601 Co-Owner Name Village: Hyannis Town Sewer At Address: Yes GIS Zoning Value: MS . Assessed Values 2013 -Map/Block/Lot: 327/202/-Use Code: 1210 2013 Appraised Value 2013 Assessed Value Past Comparisons Building $ 197,500 $ 197,500 L Year Total Assessed Value: / Value Extra $ 33,700 $ 33,700 ' 2012 - $ 360,900 Features: 2011 - $ 346,400 Outbuildings: $22,800 $ 22,800 2010 - $ 327,500 Land Value: $ 107,300 $ 107,300 2009 - $ 339,000 2008 - $ 339,300 2013 Totals $361,300 $361,300 ' ' 2007 - $ 338,800 Residential Exemption Received=$88,785 2 . Tax Information 2013 -Map/Block/Lot: 327/202/-Use Code: 1210 Taxes r j , /r ,�., �< Hyannis FD Tax(Residential). $ 722.60 CIA" Community Preservation Act $ 72 02 Tax `'� Town Tax(Residential) 2,400.73 Fiscal Year 2013 TAX RATES HERE 3,195.35 . Sales History-Map/Block/Lot: 327/202/-Use Code: 1210 History: Owner: Sale Date Book/Page: Sale Price: LAROCHE, GLENN M 11/14/1996 10482/117 $133000 BOYD,AGNES P 6/8/1971 1513/805 aS o $0 . Photos 327/202/-Use Code:,1210 http://www.town.bamstable.ma.us/Assessing/printI3.asp?ap=0&searchparce1=327202 2/27/2013 =Loop Up Print Page 2 of 3 - There are not any photos for this parcel . Sketches-Map/Block/Lot: 327/202/-Use Code: 1210 MT�2.0] � sl f s AsBuilt Card N/A . Constructions Details- Map/Block/Lot: 327/202/-Use Code: 1210 Building Details Land Building value $ 197,500 Bedrooms 7 Bedrooms USE CODE 121( Replacement Cost $232,298 Bathrooms 5 Full Lot Size(Acres) 0.41 Model Residential Total Rooms 11 Rooms Appraised Value $ 10'. Style Colonial Heat Fuel Gas Assessed Value $ 10 Grade Average Heat Type Hot Air Year Built 1820 AC Type None Effective depreciation 15 Interior Floors HardwoodPine/Soft Wood Stories 2 Stories Interior Walls Drywall Living Area sq/ft 2,564 Exterior Walls Wood Shingle Gross Area sq/ft 3,721 Roof Structure Gable/Hip Roof Cover Asph/F GIs/Cmp . Outbuildings & Extra Features-Map/Block/Lot: 327/202/-Use Code: 1210 Code Description Units/SQ ft Appraised Value Assessed Value FEP Enclosed porch- 24 $ 2,600 $2,600 roofceiling UST Utility Storage- 25 $400 $400 attached FPL3 Fireplace 2 story 1 $4,300 $4,300 http://www.town.bamstable.ma.us/Assessing/printl3.asp?ap=0&searchparcel=327202 2/27/2013 z;Loop Up Print Page 3 of 3 BRN1 Barn- 1 Story 560 $ 10,800 $ 10,800 BMTI Basement- 560 $ 12,000 $ 12,000 Unfinished FOP Open Porch-roof- 388 $ 10,300 $ 10,300 ceiling BMT Basement- 720 $ 16,100 $ 16,100 Unfinished . Sketch Legend Property Sketch Legend B2N Barn-any 2nd story area FPC Open Porch Concrete Floor REF Reference Only BAS First Floor, Living Area FTS Third Story Living Area(Finished) SOL Solarium BMT Basement Area(Unfinished) FUS Second Story Living Area(Finished) TQS Three Quarters Story(Finish( BRN Barn GAR Garage UAT Attic Area(Unfinished) CAN Canopy GAZ Gazebo UHS Half Story(Unfinished) CLP Loading Platform GRN Greenhouse UST Utility Area(Unfinished) FAT Attic Area(Finished) GXT Garage Extension Front UTQ Three Quarters Story(Unfinis FCP Carport KEN Kennel UUA Unfinished Utility Attic FEP Enclosed Porch MZ1 Mezzanine, Unfinished UUS Full Upper 2nd Story(Unfinisl FHS Half Story(Finished) PRG Pergola WDK Wood Deck FOP Open or Screened in Porch PTO Patio http://www.town.bamstable.ma.us/Assessing/printl3.asp?ap=0&searchparcel=327202 2/27/2013 Town of Barnstable, MA Page 1 of 1 Town of Barnstable,MA Wednesday,February 27,2013 § 240-24.1.4. MS Medical Services District. [Added 7-14-2oos by Order No. 2005-1001 A. Permitted uses.The following principal and accessory uses are permitted in the MS District. Uses not expressly allowed are prohibited. (1) Permitted principal uses. (a) Single-family dwellings. (b) Two-family dwellings. (c) Business and professional offices. (d) Nursing homes. (e) Medical/dental clinics. (f) Hospitals (nonveterinarian). (g) Bed-and-breakfasts. (h) Multifamily housing totaling not more than six dwelling units per acre or 12 bedrooms per acre. (i) Mixed-use development. (2) Permitted accessory uses. (a) Family apartments. (b) The following uses shall only be permitted as ancillary operations to a hospital, nursing home,or other medical-oriented facility: [1] Personal services,such as barber or beauty shops. [2] Banking services. [3] Restaurants. http://ecode360.com/printBA2043/form?guid=6558665 2/27/2013 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 9` Map Parcel 9 .3,;2 7 2 6t--L Permit# Health Division Date Issued 0� Conservation Division Fee ` Tax Collector I U, -� • A- Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address l i 'J M A/ tJ 6*e " Village 1VA ludo i j Owner l—S'Le IO A J�C_f'�"� Address :S/ Telephone -7-71 ,r.�7�2 /�l���l�ii��r %� /��-/�K Permit Request DPI-MO Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Estimated Project Cos Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes,-attach supporting documentation.- Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes &lo On Old King's Highway: ❑Yes 9lo Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other C46 e-4po 4�le Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing /� new First Floor Room Count Heat Type and Fuel: Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes /No Fireplaces: Existing ✓ New Existing wood/coal stove: ❑Yes gNo Detached garage:❑existing ❑new size Pool:O existing ❑new size Barn:❑existing ❑new size Attached garage-Axisting ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use t"66 A ° Proposed Use BUILDER INFORMATION Name� Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CON TR ION EBRIS ESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATU DATE t ~� FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED , 1 MAP/PARCEL NO. r, ; ADDRESS `. VILLAGE OWNER DATE OF INSPECTIq.�I: w FOUNDATION FRAME INSULATION FIREPLACE } r ELECTRICAL: ROUGH FINAL � f > PLUMBING: ROUGH FINAL '* GAS: ROUGH FINAL FINAL BUILDING r , DATE CLOSED OUT ASSOCIATION PLAN NO. R The Commonwealth ofMassachusetts Department of Industrial Accidents A 7 Est/ SON 600 Washington Street Boston,Mass. 02111 Workers' Com ensation Insurance davit GG name: � location: �5 �� � Ate. hone#�771 �1% city I am a homeowner performing all work myself. -S� /Yf C ❑ I am a sole p etor and have no one working in anv Capacity /%/////I //D%/%//.%----U/////O�%EGi�'//� G � //%/%%///////%//%//O//////%%/%///O/O//%/////%//%///////////%%////O%////%%O////////%//%%%/ workers' compensation for my employees working on this :_ ; ;:;::<:.:.:;;;;>:;.;::;»::; ;;;;«>::>; I am an employer prwidmg . .............. .....:,:..:....:::.:::::;.;;:.:.:..:. ;:....::.:::::. :.>::.:::.::::.:.::.:::::.::;:,.:::..::.::.:.:.::.: ::::::.::.::::::::::::..::. com anv naate: addre . . ......,.....:,..... ..... insurance co. ❑ I am a sole proprietor,general contractor, or homeowner(circle one)and have hired the contactors listed below who have ' compensation polices: the following �P....... ..... .P ..::::... ::::.:.:...: :..:::. .... :::::.:.::.::.:::.::::::. ..::.::..........::::::::::.:.:.::.::::::::::::::::::.::::::..:::::. m anv nam ....._::..::::. ::...:.;.:..,.. addre .. .....:.. :+:rN.•:?''vi:t<•::3i:::;i:}iii:}{}t5i`:�.i:{:`??i':::jii:�-T:?::i::!iL:>.ti?tii�i:�:>}::j:ti?i::>r"i isi>'�?'r%`:�ii +iii:':,<:�!'i�i:5{?{4i......:<•iwT:•ii:•i):t:v. {:};<:isi;;:iiiii'ititi�iv:�{:>rf::'::�i•:::>::�:�;�:?.........:.:......:...::.�..: .. ...., ..:: ':;ii: st?%?:';: :?:;: :::.:j:::i`:}:iiv}:{:}::;.<: :•::j::; : .Y'..`.' +`;!i> ...........:....:....................................................::.................... hors ................................................................ ....................................................................... c anv na Tlle:... :<::i>i:z;::-r:;•:>:::•»>:;:;-;+:;::• •;::P:......... ;>i:>;i::::5:'S5i address <:»:>......::;<;::;>::>::<:;»::>:;.:>>:>:><::>::::::: one ...............::.::.::.::;.::::::-::::::.:.:.::.:.;-.;.:.;;::::<.;;,.:.:;:::.:.::;.. . .,...... ........ . ..: lice#:> .. ....... ... .... :. :.. insnrance� 8 Hired wider Section 25A of MGL 152 can lead to the imposition of crhnmai penalties of a Hne ap to S1,S0o o0 and/or Fafinre to a cov required understsud that a one yam, prise } the form of a STOP WORK ORDER and a fine of 5100.00 a days abut me. I copy of stateln b forwarded to the O f Investigations of the DIA for coverage verification. I do her Gerd /and of penury that the information provided above is tmp and correct i Date signature / ' tamp �=C-_ -A)0 LA )V�..�.��...Y L PhoneM Peat name ot$cial use only do not write in this area to be completed by city or town official city or town: permit/license/t ❑Buaftg Department ❑Licensing Board response is aired ❑Selednien's Office ❑check if immediate required QHealth Department phone contact person: - #; ������' (tgvued 9195 P1A) 1HE The Town of Barnstable Y Y • BAMSPABM • MAS& Department of Health Safety and Environmental Services a Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any'pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain a ceptions,along with other requirements. Type of Work: Estimated Cost��� ��� � Gd Address of Work: Owner's Name: Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑r0wrier lding not owner-occupied pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR.APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. NED UNDER PENALTIES OF PERJURY I hereby apply for a permit th agent of the owner:, 1� Date o actor Name Registration No. O Date Owners ame q:forms:Affidav f The Town of Barnstable - T '0"'ti° Department of Health Safety and Environmental Services M } Building Division } } 9 MA� 367 Main Street,Hyannis MA 02601 s639• �0 �ArED MA'1 A ' Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION:_ J �/��" V 11414-041A//_ number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: P1 city/tdwn state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) Th and rsign "homeowner"assumes responsibility for compliance with the State Building Code and P Y P g er ap licab a coded, laws,rules and regulations. The un s ned"h wner"certifies that he/she understands the Town of Barnstable Building Depart minimu ins ction procedures and requirements and that he/she will comply with said proce r and e,u r ature IS omeowner Approval of Building Official } Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Q:FORMS:EXEMPTN The Town of Barnstable ? „n, : Department of Health Safety and Environmental Services MAM m� Building Division a _ sbs� . Eon 367 Main Street,Hyannis MA 02601 k, Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner April 27, 1999 Glenn LaRoche 15 Park Square Hyannis, MA 02601 Re: SPR-039-99 LaRoche Lodging, 115�,,M_ i $tree4 Hyamus (327/202) 'Proposal:The Applicant proposes to change the use to renting of rooms to not more than 10 persons by a family residing in the dwelling. Dear Mr. LaRoche, The above referenced proposal was reviewed at the Site Plan Review Meeting of April 15, 1999 and approved under Section 4-7.4 (2) of the Barnstable Zoning Ordinance with the following conditions: • The Applicant must obtain a building permit to modify kitchens to bring pro e ato conformance. • Occupancy by owner. • The Applicant must obtain a Lodging House license from the Licensing A—Uffi0fity. This site is located within the PRD Zoning District and therefore a permitted use. Please note a Building Permit is necessary prior to any construction. Upon completion of all work,a letter of certification is required by Section 4-7.8 (7) of the Town of Barnstable Zoning Ordinance must be submitted. Also, all signage must be discussed with Gloria Urenas of this Division. Respectfully, i Ralph Crossen Building Commissioner rx LA SPR-039-99 LaRoche Lodging, 115 Main Street,Hyannis(327/202) • proposal: The Applicant proposes to change the use to renting of rooms to not more than 10 The applicant reviewed the proposal which persons by a family residing in the dwelling. - would restore the property to an owner-occupied Applicant r indica indicated barrels would be in a storage area on 6� • e. Health addressed trash collection. the side of the barn. Fire commented that metal cans with metal covers would be acceptable. If the applicant changes to a dumpster,Fire needs to review location. • Building Commissioner explained that this was an enforcement action and this applicant is restoring the property to a use allowed by right. Applicant indicated he will live there and would be hoping to rent 9 rooms to the limit allowed. • planning questioned 3 kitchens in a single family house. The Building Commissioner indicated 2 kitchens would be removed and that a site visit would be necessar . • Engineering addressed parking. There is a gravelpa rking area with 10 spaces. • APPROVED with conditions: • Obtainin a buildin ermit to modify kitchens to bring property into conformance. • Occupancy by owner. I BA A8; IN �.. - Rr"M ssa a• ' '13 MAY -7 A10 :52 Town of Barnstable Growth Management Department Hyannis Main Street Waterfront Historic District Commission www.town.barnstable.ma.us/hyannismainstreet . Decision —Certificate of Appropriateness 115 Main Street— Roof, Windows, Doors, Siding, Painting The Hyannis Main Street Waterfront Historic District Commission, pursuant to the Code of the Town of Bamstable Chapter 112, Historic Properties,Article III, Hyannis Main Street Waterfront Historic District, hereby approves a Certificate of Appropriateness for the following property: Property Address: 115 Main Street, Hyannis Assessor's Map/Parcel: 327 202 At the May 1, 2013 hearing, after consideration of the testimony given and materials submitted by the applicant and members of the public, the Commission found the proposal to replace the roof; replace and re-size four (4) windows, replace two(2)doors, repaint the front, re-shingle the side and rear will not detract from the historic character of the Hyannis Main Street Waterfront Historic District. The Commission considered the proposed window materials and color, the location of the structure, and past alterations made to the main structure on the property and found the proposed repair and replacement to be appropriate for the protection and preservation of the district. Based on these findings, the Commission voted to grant the certificate of appropriateness subject to the following conditions: 1. Roof: Remove existing two(2)layers of asphalt roof shingles; repair framing.&sheathing and re-roof with three-tab asphalt or architectural grade 2. Exterior Siding: Remove existing shingles; make any necessary framing and sheathing repairs and re-side with white cedar shingles which may be painted white(front)or left to weather naturally(side&rear) 3. Windows: Remove four(4)existing wood frame windows and replace with vinyl,energy efficient replacement windows in a smaller(shorter)size and in comparable area 4. Doors: Remove two(2)wood entry doors and replace with fiberglass,energy efficient entry doors to be painted white of equal size. 5. Permits from the Building Division are required prior to commencing work. Present and voting in the affirmative to grant the certificate of appropriateness were: George Jessop, Paul Arnold, Marina Atsalis, David Colombo,William Cronin,Joe Cotellessa, Meaghann Kenney and Brenda Mazzeo George Jessop jr., Cha' n Date Hyannis Main Street Wate r i storic istrict Com ission cc: Charles Pisacano,Applicant y-s �.✓F�V��y�_ � �; , Tom Perry,Building Commissioner I,Linda Hutchenrider, Clerk of the Town of Barnstable,Barnstable County,Massachusetts;hJereb�y cerktfy,that� f twenty(20)days have elapsed since the Hyannis Main Street Waterfront Historic Dist;-iet Cmm ofss`ion filed thr decision and that no appeal ofdecisio as been filed in the office of the Town ClerkY ':, Signed and sealed this day of u e he painZand nalfes o e u `gn YP rJ r5� Linda Hutchenri er,Town Clerk i BOYD, AGNES / A=327=202 a Nob=7-4�7� Permit For REROOF DWELLING Location -1-5��ure, Hyannis y d AcTnes Boyd Owner ) �=' �v L Type of Construction 7ti fir'i Plot Lot Permit Granted June 1 , 19 94 Date of Inspection: -� - r -" Frame 19 cv. Insulation 19 1 Fireplace 19 - ff . Date Completed '` a° 19 F i office tst Floor): w / Assessor's of ( ) e; � � r_ �.: ,;_. Assessor's map and lot number yoi THE to` Conservation(4th Floor): i �' v a` • Board of Health(3rd floor): = 1; seas�Tante Sewage Permit number '` y rua Engineering Department(3rd floor): House number //SG11 �o asY Definitive Plan Approved by Planning Board s 19 APPLICATIONS PROCESSED,8:30 9:30 A.M.and 1:00-2:00 P.M.only -TOWN OF BARNSTABLE }BUILDI'NG ' INSPECTOR APPLICATION FOR PERMIT TO �- RO®C r TYPE OF CONSTRUCTION 19 _ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location Proposed Use Zoning District - D Fire District 119 AJ<5 Name of Owner (tf S A6 Address ' � Vp U w SQ. R'WMV,t,S Name of Builder Address`7-V�MAGI, G�I�r � dt37 9RIM Pwff 416�7F ' tE ���' Name of Architect Address Number of Rooms Foundation Exterior Roofing Floors Interior Heating Plumbing Fireplace Approximate Cost o 0 G Q Area Diagram of Lot and Building with Dimensions Fee OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name400ZR Construction Si ipervisor's License �/f Ly D I,, y ` C01 TH`OF M[1$�ACHUS TSy� ` Y `c DErAR---,1-M1ENT OF LNI?UST•RIArf►ACCIDENTs F A 600 WASHINGTON fames.. Can poei: BOSTON, MASSACHUS=02111 '. prnr sstone " WORKERS' COMPENSATION INSURANCEAFFIDAVIT ;� � 4 a ` +ir'w...r,,.+gyu� A y(ltOGtrsee!'pe[ttittiee) - ,.j: 4 v{@ - {'hs•. <v y 4:. •,r .�"w,'S .. ,m.'S` t`.3 .# �Fk,,tG �!'r yx G -4 �� '-ti,�' 4`. %i;y,.t'k with a pnnapal plaac of business/residenac =f � r��_• � . -"F... a i aY r.�"m-' -:.f 'yt ey„ }• v,} �'m+�3'"ch a+r:a± ^eY ...5. d 'h �s'a a"""�: viz -*• r.. e .. ;; ayt.. t� '�"- 3`°;uµt:•'r** < :.4•y,�R'' -.` - .`f'� .4s r+-:t.. " ,t °6'.s.�5.d 1..' ,.t "s, it r �r-..ate i, ?„�', s �,#• .s c"f {' �.'g+� ...'�. . �% ,'ykt.l ,,,t _.+v. ,a.,:, rrM"'r i ,'. 9="�4rc �a. >.£ "m.. k.F 3. '£` `c -- . ":: ram"£' 420, '�'.. _drh/'f r s 5 r`G t act �+a t Y"?` J;�5 Y> as c-a, Crflp) xx€¢s s .> u ry do herebrceriify,under the pains'and pctialtm of perjury:tEiat:M, . <v . ' �".�> am an employer providing the following workers'compensation coverage for my employees working on this x ,0, Insurance Company Policy Numbs .F i .fir k i a sole proprietor and have no one working for me. O I am a sole.proprietor, nerd contr 'or homeowner (cirde one)and have hired the contractors listed below who have the following wor crs compensation insurance policies: -- v Namc of Contractor Insurance CompanylPolicy Number, zm Dame of Contractor Insurance Company/Policy Number y_ , Name of Contractor Insurance CompanvlPolicy Number 1 am a homeowner performing all the work myself. NOTE Pleuc be aware t :t while homeowners who eruploy persous to do=inzeaanec.Construction or t:p=irwork oa a dweliinc of not more than t rec uniu in which the horcowncr aiso resicu or on the grouaas appurtenant thereto are not rcncrally considered to be employers=icr the corkers'Corrvcasation Act(CL C 152.seer. 1(S)),applieatioa bv`a ho meow oec for a license or permit may eviccace tie Iccal sutus of an employer under the Corkers'Compcosation Act. coo.•c:t:-.is s:ztc acr.:will be forty u6cd to tnc Dcp:.:^c.t of I ndus:•.:.1 Accidents'Office of lnsuranc, for covcragc yer::;.:tor.zrc :o sec..:e WVC-..Ce as recur:ec under Section 2e-.'of�;G''.5:cr.iead to t:'3_ imposition of erir.:inal peraJtiu consisc=c of:f::c of err tc S:;00.00 and/or ir•.:pri ormcnt of up to one yc:::nd cv:c pcn::tics In the form of:Stop Wort:Order and a fine of S 100.00 a day against MC. Signed this l day of N c� ��' , 1.9 Licc:ac_rPc::n�-cc �icc^sor;rcrmi—.�: 12. a r - Es �/ -Co,v ol,..�� HOME IMPROVEMENT CONTRACTORS REGISTRATION i Board of Building Regulations and Standards One Ashburton Place — Room -1301 Boston , Massachusetts 021.08 HOME IMPROVEMENT CONTRACTOR Registration 116064 Expiration 05 15/96 Type -- D B A °TloE o�✓ll000acleuaee HOME IMPROVEMENT CONTRACTOR Registration 116064 TYNDALL ROOFING Type - DBA ROBERT F . TYNDALL Expiration 05/15/96 37 BRIAR PATCH RD OS T ERVILL E PiA 02h55 TYNDALL ROOFING ROBERT F. TYNDALL G�co�iao7� &7,,WBRIAR PATCH RD ADMINISTRATOR OSTERVILLE MA 02655 p« _ TOWN OF BARNSTABLE• REPORT SUPPLEMENTARY/CONTINUATION REPORT i NAME (LAST, FIRST, MIDDLE) DIVISION /DBPI 1 NOTE DETAILS i OBSERVATIONS-ITEMIZE EVIDENCE, SERIAL SS ETC- 1 61 PAGE _ SUBMITTED BY ...:.. :. :....... / / .... :. . ........................:::.:::::::::::............................................ .. :................... ........ .... ...... ..................:... ;..B LDI ::.......................: ::PARK Sg .... x <>" ....... ..::.::::::.:. .......:::. }<' '.:: :.HYANNIS y±y� ��...�.'��.�`,�.�.',.��.��,.��'��'.'��.��...'..�'���.�ilM1l'�.:-•�`:%yv::::':::::':�`:s:;�` 4:�:� :�:� ::.� � %.`f:%.:::2:;t:?'::%���?:��?<.'���l:�:.� `�.: i`.:::%:`:::::`'�%':':'::':" :':'��}:�2'�}12 %::+': ......:.:::.. ' INS:::..:.::::.::.v:: ' as...:........:: >: .;LE4.-tM1:ALPPc'P. . . . .?????? ..:::.:::..:.::...::..:::..... 0mmilil 1 No low :SEARCH ....:..::..::::::::.:.. ::..............:.:. �L -e- � N RESIDENTIAL PROPERTY g MAP NO. LOT NO. FIRE DISTRICT a �E' STREET 15 Park Square Hyannis SUMMARY 327 202 g �t3 LAND 4�+ BLDGS. .3 A 3 7 OWNER — TOTAL RECORD OF TRANSFER DATE SK PG I.R.S. REMARKS: 7,9 LAND BLDGS. 13^2 F' a °..Raeburn-- RobinT kip :,:8e •P, .. es- , ._..._ n. .--- _.6 2, 69-._ 143g_--73(3— __ __ TOTAL - LAND d es P.- 6 8 1 1 805 BLDGS. � TOTAL r 3 ("?Oeh' 6� LAND Cl) BLDGS. ' TOTAL :., LAND ' BLDGS. TOTAL ` LAND 3 BLDGS: "{. TOTAL LAND } BLDGS. Of _ TOTAL LAND INTERIOR INSPECTED: / BLDGS. ' DATE: 5 / �/ — TOTAL / LAND ACREAGE 9,1041PILITAtIONS BLDGS. D TYPE # OF ACRES PRICE TOTAL DEPR. VALUE TOTAL HOUSE DODO 2-5- o o Zp5 lqzon LAND 'CLEARED FRONT BLDGS. REAR TOTAL WOODS&SPROUT FRONT JLDG REAR WASTE FRONT REAR LOT COMPUTATIONS LAND FACTORS TOTAL FRONT DEPTH STREET PRICE DEPTH% FRONT FT.PRICE TOTAL DEPR. COR. INF. VALUE HILLY TOWN SEWER kLANDRQUGH TOWN WATER 0)HIGH GRAVEL RD. LOW DIRT RD. LAND SWAMPY NO RD. BLDGS. FOUNUATION teals I « + i�.r 1 h��1�..� — - • � �..�• LAND COST 'Conc.Walla Fin.Bsmt.Area Bath Room j Base —...�' U 3 0 _ BLDG. COST _ j Cone.Blk.Walls Bsmt.Rec. Room St. Shower Bath Bsmt. PURCH. DATE Cone.Slab .. Bsmt.Garage St. Shower Ext. Walls PURCH. PRICE Brick Walls Attic FI. &Stairs Toilet Room Roof RENT Stone Wells Fin.Attic IV Two Fixt. Bath — Piers INTERIOR FINISH Lavatory Extra Floorsp Bsmt. F 1 2 3 Sink sjj r/x r/' Plaster Water Clo. Extra Attie 'gyp /S EXTERIOR WALLS Knotty Pine Water Only s 3 S o 0 Bsmt.Fin. Double Siding Plywood No Plumbing ` Single Siding Plasterboard 7 E Int.Fin. -W'd Shingles TILING p ;one.Blk. _ G F P Bath FI. Heat O Face Brk.On ,Int.layout Bath FI.&Wains. S L lyT Auto fit.Unit p •3 t Y 5 '' Veneer Int.Cond. Bath Fl. &Wells Fireplace mom. Brk.On HEATING Toilet Rm.FL. plumbing a Solid Cam.Brk. Hot Air Toilet Rm.FI.&Wains. `� J� -- Tiling Steam Toilet Rm.FI.&Walla Blanket Ins. Hot Water St. Shower ,7 X/0 Roof Ins. Air Cond. Tub Area Total Floor Furn. 3 N ie ROOFING COMPUTATIONS iV Asph.Shingle Pipeless Furn. 60 S.F. 3 y{p.Z 0 3O i0 3trS d P Wood Shingle No Heat S. F. s-7 eI'/ /0 Asbs.Shingle Oil Burner C S.F. /.S/0 36 . �. • �j . .. . State Coal Stoker n S.F. U 370 13)N. Tile Gas ROOF TYPE Electric S.F. /�',y�j y<O OUTBUILDINGS S.F. 6•3 0 )yt 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10 MEASURED Gable Flat Hip Mansard FIREPLACES S.F. /7.0-0 ,�/S' Pier Found. t/ Floor _ Gambrel Fireplace Stack "'7 — 1740 Wall Found. 0:H.-'Door LISTED FLOORS Fireplace �'� 7, S6 8 Sgle.Sdg. Roll Roofing � Cone. LIGHTING !c r� 4_3 p / Dble.Sdg. r/ Shingle Roof Earth No Elect. DATE Pine Shingle Walls Plumbing � Hardwood ROOMS Cement Blk. Electric Asph.Tile Bsmt. 1st '�_ (� TOTAL y 7 p Brick Int. FinishAWED. 73 - Single 2nd�.�a 3rd FACTOR REPLACEMENT —A Gal OCCUPANCY CONSTRUCTION SIZE AREA CLASS AGE REMOD. CONO. REPL. VAL. Phy.Dep. PHYS. VALUE Funct.Dep. ACTUAL VAL. DVVLG. g— m 4 C : ; SCE �' 31 S7 3 iSS O ; 2 3 4 5 6 7 B \ 9 10 TOTAL � � � � � �� � �� � � � 3 � � �i �v � �� � � �� - - --� � _ ' � � ', � � ', b __ The Town of Barnstable MAM„►�,,Ar,�I,E, : Department of Health Safety and Environmental Services Building Division iOrEo a 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner April 27, 1999 Glenn LaRoche 15 Park Square Hyannis, MA 02601 Re: SPR-039-99 LaRoche Lodging, 115 Main Street, Hyannis (327/202) Proposal:The Applicant proposes to change the use to renting of rooms to not more than 10 persons by a family residing in the dwelling. Dear Mr. LaRoche, The above referenced proposal was reviewed at the Site Plan Review Meeting of April 15, 1999 and approved under Section 4-7.4 (2) of the Barnstable Zoning Ordinance with the following conditions: • The Applicant must obtainsbuilding-permit-to:modify=kitchens_to bring proper-ty into conformance • Occupancy by owner. • The Applicant must obtain a Lodging House license from the Licensing Authority. This site is located within the PRD Zoning District and therefore a permitted use. Please note a Building Permit is necessary prior to any construction. Upon completion of all work, a letter of certification is required by Section 4-7.8 (7) of the Town of Barnstable Zoning Ordinance must be submitted. Also, all signage must be discussed with Gloria Urenas of this Division. Respectfully, Ralph Crossen Building Commissioner SPR-039-99 LaRoche Lodging, 115 Main Street,Hyannis (327/202) • Proposal: The Applicant proposes to change the use to renting of rooms to not more than 10 persons by a family residing in the dwelling. The applicant reviewed the proposal which would restore the property to an owner-occupied lodging house. • Health addressed trash collection. Applicant indicated barrels would be in a storage area on the side of the barn. Fire commented that metal cans with metal covers would be acceptable. If the applicant changes to a dumpster,Fire needs to review location. • Building Commissioner explained that this was an enforcement action and this applicant is restoring the property to a use allowed by right. Applicant indicated he will live there and would be hoping to rent 9 rooms to the limit allowed. • Planning questioned 3 kitchens in a single family house. The Building Commissioner indicated 2 kitchens would be removed and that a site visit would be necessary. • Engineering addressed parking. There is a gravel parking area with 10 spaces. • APPROVED with conditions: • Obtaining a building permit to modify kitchens to bring property into conformance. • Occupancy by owner. R - 1 [R327 202 . q ] LOCI 0015 PARK SQiJPri CTY] 07 TDS] 400 HY KEY] 243043 ---MAILING ADDRESS------- PCA] 1011 PCS] 00 YR] 00 PARENT] 0 LAROCHE, GLENN M MAP] AREA] P015 JV] 315199 MTG] 9102 15 PARK SQUARE SP1] SP21 SP31 UT11 UT21 .41 SQ FT] 2564 HYANNIS MA 02601 AYB] 1820 EYB] 1975 OBS] CONST] 0000 LAND 25500 IMP 154300 OTHER 3400 ----LEGAL DESCRIPTION---- TRUE MKT 183200 REA CLASSIFIED #LAND 1 25, 500 ASD LND 25500 ASD IMP 154300 ASD OTH 3400 #BLDG(S) -CARD-1 1 154, 300 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE #OTHER FEATURE 1 3 , 400 TAX EXEMPT #PL 115 MAIN ST HYANNIS RESIDENT'L 183200 183200 183200 #RR 1209 0091 OPEN SPACE COMMERCIAL INDUSTRIAL EXEMPTIONS SALE] 11/96 PRICE] 133000 ORB] 10482117 AFD] I LAST ACTIVITY] 01/07/97 PCR] Y ...r. R327 202 . • P P R A I S A L D A T Jo KEY 243043 LAROCHE, GLENN M LAND BLD/FEATURES BUILDINGS NUMBER ZN/FL=PRD 25, 500 3 , 400 154, 300 1 A-COST 183 , 200 B-MKT 215, 700 BY 00/ BY /00 C-INCOME PCA=1011 PCS=00 SIZE= 2564 JUST-VAL 183 , 200 LEV=400 CONST-C 0 ----COMPARISON TO CONTROL AREA P015 ----------------------------- PROFESSIONAL ZONE PARCEL CONTROL AREA TREND STANDARD 101 30 LAND-TYPE 255001 LAND-MEAN +0% 1832001 IMPROVED-MEAN +Oo 500 ] FRONT-FT ] 100 DEPTH/ACRES TABLE 02 100011 LOCATION-ADJ APPLY-VAL-STAT 1 LNR] LAND LFT/IMP] ADJS/SB/FEAT STR] STRUCTURE ARR] AREA-MEASUREMENTS NOR] NOTES COM] MARKET INC] INCOME PMR] PERMITS GRR] GRAPHIC FUNCTION- [ ] STRUCTURE-CARD NO- [0 0 0] DATA- [ ] XMT [?] r. or R327 202 . • P E R M I T [PMT] ACT*[R] CARD [000] KEY 243043 000000001 PERMIT—NO MO YR TYPE VALUE CK—BY MO YR oCMP NEW/DEMO COMMENT [B36747] [06] [94] [AD] A 48001 [LK] [01] [95] [100] [NEW ] [HY REROOF ] [ ] [ l [ J [ ] ] [ ] [ J [ ] [ ] [ ] [ ] [?] I r LEASE EXHIBIT: THIS LEASE IS SCHEMATIC IN NATURE � � " AND IS INTENDED TO PROVIDE GENERAL INFORMATION REGARDING THE I LOCATION AND SIZE OF THE PROPOSED ., ka e• T � WIRELESS COMMUNICATION FACILITY, •. - . THE SITE LAYOUT WILL BE FINALIZED UPON COMPLETION OF THE SITE m40 SURVEY AND-FACILITY DESIGN. V!r a x + ro �� t STRUCTURAL NOTE, � f a,- A STRUCTURAL ANALYSIS SHALL BED r PERFORMED ON EXISTING UTILITY POLE a ' PRIOR TO CONSTRUCTION AND SHALL z �' BE THE RESPONSIBILITY OF UTILITY CO. , m INSTALLATION NOTE: _ , r . ,, .Fa. • ° INSTALL ALL EQUIPMENT, MOUNTING _ • a• ww BRACKETS AND HARDWARE IN ' b ACCORDANCE WITH MANUFACTURER'S " RECOMMENDATIONS ELECTRICAL NOTE: GENERAL WIRING DIAGRAM AND . NOTES TAKEN FROM E=MEMO BY u JAMES F. GVAZDAUSKAS, P.E. • , * �, � .' t � DATED JANUARY, 12 2017 e� �- • a• �'+- f � - �> � COORDINATED NOTE: COORDINATES AND AMSL ELEVATION � �• WN " BASED FROM FAA-2C CERTIFICATIONIlk DATED 08/09/2016. A METES AND BOUNDS SURVEY WAS NOT CONDUCTED • ^ '� A w • it r � , T s Y � w a : x m a , LEGEND (F) = FUTURE (BLACK) (E) = EXISTING (YELLOW) -- (P) = PROPOSED (BLACK) APPROX. LOCATION (E) UTILITY POLE TRUE NORTH (AGL) = ABOVE GROUND LEVEL. SUBJECT POLE FALLS WITHIN THE (AMSL) = ABOVE MEAN SEA LEVEL NAD 83 LATITUDE: -41' 39' 20.59' 1 SITE PLAN TOWN'S RIGHT OF WAY. N.T.S. = NOT TO SCALE NAD 83 LONGITUDE: —70' 16' 29.69" - MASSDOT HIGHWAY LAYOUT PLAN (WHITE) GROUND ELEVATION: 28.0' AMSL LE-1 SCALE: 1'=50' 0 25' 50' 100' , H YA N N I S SC 10 M A LEASE EXHIBIT DATE: 02/27/2017 DRAWN BY: SMB ADVANCED ver��onwireiess DRAWING NUMBER REVISION CHECKED BY: SNA ENGINEERING GROUP, P.C. VERIZON WIRELESS 115 MAIN STREET SCALE: 1"=50' Civil Engineering-Site Development 400 FRIBERG PARKWAY -HYANNIS, MA 02601 HYANNIS_SC10_MA Surveying-Telecommunications WEST'BOROUGH. MA 01581 4 SHEET: 1 OF 5 (P) 1200 X 38.7H NH360QM—DG-2XR TOP (P) ANTENNA ANTENNA MOUNTED TO (P) UTILITY POLE ELEV. = 36.4'f AGL (64.4'f AMSL) (P) 12.0.0 X 38.7'H NH360QM—DG-2XR (P) 4' EXTENSION POLE ,..+' ANTENNA MOUNTED TO (E) (P) ANTENNA GROUND WIRE -----_--_ OF (P) ANTENNA UTILITY POLE ELEV. 34.6'f AGL (62.6't AMSL—) �'r � `� ��' (P) 4' EXTENSION POLE VERIZON (P) 1�' COAX CABLES (TOTAL OF 2) & (1) RET (E)UTILITY TALL 133-54 UTILITY POLE #33-54 TOP (E) UTILITY POLE CABLE IN 2' U—GUARD TO (P) ANTENNA ^ (P) POWER WEATHERHEAD ELEV. 28.5't AGL (56.5't AMSL) '" ` E STREET LIGHT E SECONDARY POWER LINE AiN ELEV (26.0' f AGL 54.0 t AMSL _ ELEV. 26.0' t AGL (54.0' t AMSL) BOTTOM OF STREET LIGHT ARM 4 1' ot�� ll ELEV. 24.5' AGL 52.5 f AMSL ,� a y e , E TELCO COAX ELEV. 22.0 t AGL 50.0 f AMSL a— art0.— °" "a` (E) 28.5' TALL VERIZON.UTILITY POLE #33-54 (P) RRH'S (TOTAL OF 2), (2)(P) E TELCO COAX `— w .m DIPLEXERS, & (2)(P) DELTA - AC/DC CONVERTERS MOUNTED ELEV. 20.5 t AGL 48.5 f AMSI (P) RRH'S (TOTAL OF 2). (2)(P) DIPLEXERS, & (2)(P) TO (E) UTILITY POLE DELTA AC/DC CONVERTERS MOUNTED TO (E) UTILITY POLE 41 (P) POWER TO (P) METER FROM PROVIDER 411 (P) FIBER. 2' U—GUARD TO (P) SAR-0 BOTTOM OF (P) RRH ob (P) � (P)Xz' COAX CABLES (TOTAL OF 4) TO DIPLEXERS ELEV. = 12.5'f AGL (40.5'f AMSL) (P) SAR-0 6GA-2 POLE I (P) ELEC. RGS I SWITCH FUSED WITH (3)20A T CONDUIT TO (P) METER r CSOCKIRCUIT BREAKERS & METER ET 6OA-2 POLE DISCONNECT SWITCH FUSED WITH U-' � = x (3)-20A CIRCUIT BREAKERS & METER SOCKET °O (P) GROUND WIRE FROM (P) M R METER TO (P) GROUND ROD E GROUND LEVEL ELEV. = 0 t AGL 28.0 t AMSL (P) GROUND ROD 2 PHOTO E L E VAT I O N LE-2 SCALE: 1'=10' LEGEND (F) = FUTURE (BLACK) 1 E L E VAT I O N A INSTALLATION NOTE: STRUCTURAL NOTE: (E) = EXISTING (GREY) �-2 SCALE. 1'=10' INSTALL ALL EQUIPMENT, MOUNTING A STRUCTURAL ANALYSIS SHALL BE (P) = PROPOSED (BLACK) BRACKETS AND HARDWARE IN PERFORMED ON EXISTING UTILITY POLE (AGL) = ABOVE GROUND LEVEL 0 51 20 ACCORDANCE WITH MANUFACTURER'S PRIOR TO CONSTRUCTION AND SHALL (AMSL) = ABOVE MEAN SEA LE1h7,. RECOMMENDATIONS BE THE RESPONSIBILITY OF UTILITY CO. N.T.S. = NOT TO SCALE �✓'�� HYAN N IS_SC10_MA LEASE EXHIBIT DATE: 02/27/2017 DRAWN BY: SMB ® ADVANCED veri w;reiess DRAWING NUMBER REVISION CHECKED BY: SNA ENGINEERING GROUP, P.C. VERIZON WIRELESS 115 MAIN STREET . SCALE: AS NOTED Civil Engineering-Site Development 400 FRIBERG PARKWAY HYANNIS, MA 02601 HYANNIS_SC10_MA . 4 Surveying-Telecommunications WESTBOROUGH, MA 01581 SHEET: 2 OF 5 INSTALLA ION NOTE9 INSTALL TALL EQUIPMENT, MOUNTING BRACKETS AND HARDWARE IN P� ACCORDANCE WITH MANUFACTURER'S ,o RECOMMENDATIONS 9 NH - X 38.7"H 0QM (E) OVERHEAD ELECTRIC ANTENNA ANTENNA MOUNTED TO STRUCTURAL NOTE: Yqr (P)' UTILITY POLE A STRUCTURAL ANALYSIS SHALL BE PERFORMED ON EXISTING UTILITY POLE (E) CONCRETE SIDEWALK PRIOR TO CONSTRUCTION AND SHALL (E) STREET LIGHT (P) 12. "0 X 2XR 38.7"HANTENNA (P) 4' EXTENSION POLE BE THE RESPONSIBILITY OF UTILITY CO. (E) OVERHEAD ELECTRIC P, MOUNTED TO (P) UTILITY POLE / (P) AWS RRH, (P) PCS RRH, (P) AC/DC (E) 28.5' TALL VERIZON CONVERTER, (2)(P) DELTA AC/DC CONVERTERS, UTILITYSPOLE��R54 IZON UTILITY POLE #33-54 (2)(P) DIPLEXERS, 60 AMP METER SOCKET W/DISCONNECT MOUNTED TO (P) UTILITY POLE TRUE NORTH 4 ANTENNA PL N K5 ANTENNA MOUNTING DETAIL. LE-3 SCALE: 1"=8' LE-3 SCALE: 1"=4' " f► 9.51 �{ e (P) 4' EXTENSION POLE _ 12.0" eeee ee 2 7.3" o00o e eo e o e e o 00 a eeee ee X, - (U eeee °e COMMSCOPE NH360QM-DG-2XR a eeee o o DIMENSIONS: 12.0"0 x 38.7" p WEIGHT: 33.7 LBS o o e e e e 13 t- p p 'e ( 3.2"40 6 PCS RRH iy MIOGHF. 560 LBS. a , � a 06 _ �. M 12.0' 7.6'kxl� p Zl- mQE;eeee ee In � ' •, S` - OJ oeee e o FRONT 1 6 e o 0 WIRELESS CONSTRUC110N, INC. POL"ALL MOUNT FOR DUAL DIPLEXER FRONT RADIO BRACKET _ SIDE ITEM DESCRIPTION arr. DIMENSIONS: 7.6"H x 7.3W x 3.2"D LEGEND AWS 9OW RRH 1 DOUBLE MOUNT 2 WEIGHT: 6.6 LBS UNIT WEIGHT 67.0 LBS 2 suCS LRm FWRDWARE 1 (F) = FUTURE (BLACK) a sI1i�PP Um RACK W/ WIDWAARE 1 NOTE: MOUNT DIPLEXERS TO BACKSIDE (E) = EXISTING (GREY) OF DBL-MNT BRKT (P) = PROPOSED (BLACK) 1 ANTENNA DETAIL 2 RRH DETAILS 3 DIPLEXER DETAIL (AGL) = ABOVE GROUND LEVEL LE-3 SCALE: N.T.S. LE-3 SCALE: N.T.S. (AMSL) = ABOVE MEAN SEA LEVEL LE-3 SCALE: N.T.S. N.T.S. = NOT TO SCALE � EXHIBIT DATE: 02�2��201HYANNIS_SC10_MA LEASE` ,, � DRAWN BY: SMB e V@IllwirelessADVANCED DRAWING NUMBER REVISION CHECKED BY: SNA ENGINEERING GROUP, P.C. VERIZON WIRELESS 115 MAIN STREET - SCALE: AS NOTED Civil Engineering-Site Development 400-FRIBERG PARKWAY HYANNIS, MA 02601 HYANNIS_SC10_MA 4 Surveying-Telecommunications WESTBOROUGH, MA 01581 SHEET: 3 0F 5 PROPOSED _ ANTENNA ANTENNA MOUNT/BRACKET ANTENNA GROUNDING (2) 1/2" COAX CABLES & (1) RET - (DEPENDING ON ANTENNA MODEL) CABLE IN 2" W RATED U-GUARDS I SECONDARY LINES N WEATHER HEAD (LEAVE 10' CONDUCTORS FOR UTILITY , CO. TIE INS) FIBER FRONTHAUL & BACKHAUL FIBER DEMARC ON POLE (2) DIPLEXER FIBER JUMPERS IN 1-1/2" UV '(4) 1/2" COAX RATED U-GUARD IF LENGTH CABLES EXCEEDS 4' j-- AWS RRH PCS (3)#6 AWG WIRE IN FIBER JUMPER (TYP.) RRH 1-1/4" UV RATED PVC, DC POWER 12 AWG COPPER GROUND DELTA AC/DC CONVERTER "(TYP•) (M. OF 2) WEATHER PROOF SQUARE D CAT AC POWER NOTE: USE PROVIDED DELTA NO.: SDSA1175 SECONDARY SURGE MANUFACTURERS WIRING HARNESS k ARRESTOR ON 20A 2P. CIRCUIT BREAKER - #2 AWG COPPER SQUARE D QO-100A, 8 SPACE, 16 CIR OUTDOOR . OM GROUND IN 1/2' ` m MAIN LOAD CENTER WITH COVER. 60A 2P MAIN UV-RATED PVC, CIRCUIT BREAKER WITH (3) 20A, 2P BRANCH CIRCUIT BREAKERS,(1 FOR SURGE ARRESTOR & (1) PER RRH) r MILBANK CAT NO.: f - U2272-RL-5T9-BL SINGLE LEVER 120/24OV, If 3W 125A METER" 3/4"00 0' COPPER CLAD GROUND ROD , ELECTRICAL NOV- GENERAL WIRING DIAGRAM AND 1 GENERAL WIRING DIAGRAM NOTES TAKEN FROM E-MEMO BY JAMES F. GVAZDAUSKAS, P.E. LE-4 SCALE: N.T.S. DATED JANUARY 12, 2017 HYAN N IS SC10 MA LEASE EXHIBIT 2 DATE: 02/27/2017 4 — DRAWN BY: SMB N- ADVANCED very onwireiess DRAWING NUMBER REVISION CHECKED BY: SNA ENGINEERING GROUP, P.C. 115 MAIN STREET VERIZON WIRELESS SCALE: AS NOTED Civil Engineering-Site Development 400 FRIBERG PARKWAY: HYANNIS, MA .02601 HYANNIS_SC10_MA 4 Surveying m -TelecommunicationsWESTBOR OUGH MA 0 _15 1 vs SHEET: 4 OF 5 g GENERAL NOTES ELECTRICAL AND GROUNDING NOTES STRUCTURAL NOTES: 1. NSGLL NL B01lPMEN4 MNDATIID BRACEIS AN)HIMUM INAoOQIQWLE 1. aELBCIRCL WORN SWILLCONFORM TO THEiff N REMEMENIS OF TATIONAL 1. BMW REQUIREMENTS ARE PER STATE BUILDING CODE AND APFUCABlE SII REIMBITS,ANSI/ASCE7.EM/W-222-0 WITH YMIFALTIIER S RODUOILTIDR ELBCIRCAL OME(ME)AS WELL E APPLICABLE SUITE AND LOLL NODES STRUCTURAL STANDARDS FOR SIM ANTENNA SIPPORING STRICTURES --1 GMOILID 06T1®IIIIQN BOXES,MOILING PLPFS AND RRIb(AS APPInew N 2. ALL ELECTRON.ITEMS SHALL E U.I.APPROVED OR LISTED NO FROMM PER 2. CONTRACTOR SWILL%VW ALL DIMENSIONS AND CONDITIONS N THE FIELD PRIOR TO FABRICATION AND ERWION OF ANY ACCOADNLE MIN WMIFADTIRICS RDOILFN04016 SFEOFICIII1 RaIR1011S MATERIAL ANY umwx OINDIRIow SHALL BE REPORTED TD THE AYYEHTON OF TIRE CommRucrm MANAGER a mm EIRMMBNT NO MNMTNG BRM]ETS TO PIESFJSE GJM ACCESS ON POLE a THE ELBLIWCAL WORK BUM ALL LANOR AO MAELIL DESCRY B WMINGS a DESIGN AND CONSTRUCTION OF sITM1cRxK STEEL SHALL CONFORM To THE AMERICAN NsnME OF STEEL CONSTRICTION No SPBXHD=NGUI NG NOIDE NN..WONT TO PROYOE CMREE MUM AND 'SPELTFIGIION FOR THE DESIGN,FABA'A M AND E1tE m OF SRLICTIAL STEEL FOR LRDNGS'. 4. EQUIPMENT TONSDQlID AN VERGIN ROD COW WIN APNIOYED 98.TW01L 5T51BL � 4. sYRUCRaAL AND N6COLIEFAUS SM SHALL CONFORM TO ASIM A36 STRUCTURAL STEEL UNLESS OTHERWISE NDICAIEIL 4. WAIL CQNTRACIOR SNNL PAY FEES FOR PERMITS,AND 6 RES UERE FOR a ADWatD ENONEELWNG GRDIP P.C.HAS NOT PEIMORIED A SI LICILM NW]SIS OF 0110040 SAD PERMITS AO OOORDNAION OF INSPECTIONS. L OR PPE SHALL.CONFORM TO ASM A500 COLD-FORMED WELDED&SEAMLESS CARBON STEEL snwmLR11 TUBING', 71E EMU POLE TO CARRY SUE ADNIIDNNL LOADING GRADE A OR ASM A53 PIPE STEM 131"AND HOT-GIPPED ZINC-GATED WELDED AND SEAMLESS TYPE E OR S.GRADE& . a ELECIRGAL AND MOD WIRING OUTSIDE A BUILDING NO WOSID 10 NEITHER STILL PPE SAS INDICATED ARE NM24AL.ACTUAL OUTSIDE DRUM 6 LARGER. BE N WATER Y 70IT OJMI IDD ROD 9M OBIS OR SOfDIN BD PC(AS - FOUTIED N"MIMIM LIC00101A1SN0 WHERE NeBWFD IN LOUD MITNmELE METAL aft a STRUCTURAL CONNECTION BOLTS SHALL BE HIGH STRENGTH BOLTS(BEARING TWO AND CONFORM TO ASTIR A325 UGH L STRENGTH eaus FOR snwcmK,MOATS,NQLDNO s1arARE NUTS AND PLAN HAIMM WASHERS'.ALL BOLTS SHALL BE a NFID COIDU`SHILL E SCHEDULE 40 PAC. 5/9'DNA LION. 7. ELECROW.WAIN SHILL E OOPPER WITH TYPE Mg.THEN.OR THIN NSUAIION. 7. ALL STEEL MA1QtW5 SHALL BE GALVANIZED AFTER FABRICATION N ACCORDANCE WITH ASM A123 LNC 01OT-DP GALVANIZED)ODAIINIS ON IRON NO STEEL PRODUCTS! UNLESS OVERAGE NOTED. a RM ELEELTTRGIL COHORT OR NINE BETWEEN ELECIRI'IAL uINIY DEIM1 0ID11 POIRT AND PRIMECT OWNER CELL SITE FPC AS 111000 ON THIS WN& a ALL BOLTS.ANCHORS AND MISCELLANEOUS HARDWARE SHALL BE DALVANIM N ACCORDANCE WITH ASITI A153'ZINC-CONTI G PROYOE FALL IBM PILL ROPE OOOMM 16OUTAMONN IN UTILITY OWW. 01OT-01F)ON IRON AND STEEL HWDWAR'.UNLESS OTHERWISE NOTED. A RM TELDD CDNDUr OR CABLE BTME1]I TELFPLNDIE UTILITY DEMARCATION POINT AND 9. FIELD WELDS.DRILLHaLFS.SAW CUTS AND ALL DAMAGED GALVANIZED suwADE5 SHAD.BE REPAIRED WITH AN OIC ZINC MIE T OWNER CELL SIZE TELDO CABINET NO 81S MI ET AS IOICJOED ON TO REPAIR PART COMPLYING WITH RE(IIUItE>EIB OF ASTIR A7B0.DALVMIZING REPAIR PAINT GALL HAVE 85 PERCENT ZINC BY ORINNG,PONDE RILL IBM PAL ROPE NO CRDILEE 00MUT IEASUISIG TAPE WEIGHT.ZINC BY DUNCIN tALVANEZDO GAM BRIGHT PFBaN,W CROWN OR EQUAL MUM OF APPLIED GA,LVARIZING N EACH INSOELID TELDO CWUIT REPAIR PAW SWILL BE NOT NOT LESS THAN 4 00105( 101 TIE TO DRY BETWEEN COATS)WITH A RESULTING CQIIN G 10. MERE COLOUR BEIMFMR BIS AND PROW OWNER CELL SITE PPC AND BETWEEN IRS NO 1HICHNESS REQUIRED BY ASTM A123 OR A153 AS APPLICABLE PROJECT 000 CELL SITE MOO SERVICE C IDET ARE UOEIOROUO USE PVC,MIEDIIIE 10. CONTRACTOR SHALL COMPLY WTH AWS CODE FOR PROCEDURES,APPEARANCE AND QUALM OF WELDS,AND FOR METHODS 40 CCIDUIT ABOME THE GRNMD PORTION OF THESE CQOUIIS SHALL BE PC ODMUL USED N OOR ECING WELDING.ALL WELDERS AND WELDING PROCESSES SHILL BE OUA FED N ACCORDANCE WITH AIS 11. ALL EQUIPMENT LOWED WTSIDE SNARL WOE HEIR 3R ENtMASIE 'STANDARD QUALIFICATION PROCEDURES'.ALL WELDING SHALL E DONE USING E7=ELECTRODES AO WELDING SHALL CONFORM TO ASC AND DUI.LYRE FILET WELD SAS ARE NOr SHOW PROVIDE THE MOiNAU Siff PER TARE,12.4 IN 12. PPC SUPPLIED BY I N=OEM THE ASC`MANUAI.OF STEEL OON67RUCII00".GIN EDITION. 11 0R0UI10N0 SIMLL COMPLY WITH NEC ART. 250. ADIMU LY.WJM BMW AO UNMNG PRMECIION SHWL E DOTE N ACCORQMNCE WI DI W=SITE 11. IICORECRY FAB IC TE0.DAMAGED OR OTHERWISE MISFO71NG OR NONCONFORMING MATERIALS OR CONDITIONS SHALL BE mom=SDIIWOS'. REPORTED TO THE CONSTRICTION MANAGER PRIOR TO REMEDIAL OR QORRECIIYE ACTION.ANY SUCH ACTION SHALL REQUIRE CONSTRUCTION MANAGER APPROVAL 14, MIND CUM ME SEW MINIMUM!AT BOTH ENDS LENT MRAFA TUBAS OQAX CABLE QOApN9 NITS WRIED B PROJECT OVER IL UWSTRUITS SHALL BE FORMED STEEL CHAW1E1 STRUT FRAMING AS MNDFACTURD B UNITRUT CORD,WAYTE.MI OR �g� EQUAL STRUT'WEASELS%A L BE 1 5/8-0 5/85x12Gq UNLESS OT I NMW NOTAND A SHALL LE HOr-OP N®GALVA fa UIDIDIDIO OWPB SWIVIED OM Ne it D 0014E ww WINE WITH GREEN 001.011 11IMIUM FOR AWYE WAX AFTER FlBRC171011 FOR WO WADE WMING B 1141=10 ON TIE DIRRINK 11 EPDXY ANCHOR ASHY SHALL CONSIST OF 1/r DWETER srNaESS STEEL NOW ROD WIN NUTS 3 WA;;IM AN 1a ALL GUM OXNNECIIOIIS 10 BE BMW IIYOROULO 001PIIFS90H TYPE OOMECIOItS INTERNALLY WELDED NSENT.A SCRE N TUBE AND A EPDXY ADHESNE.TIRE ANCHORING SYSTEM SHALL BE THE HLTI-Hr W-20 OR CAdM1D ENDEMIC WELL OO Nor ALLOW BADE OOPPBR WE TO E N OOINIACT RFD OR HNr-15o SYSTEMS(p5 SPECIFIED AN DWG)OR ENGIEELiS A4IDVED EAUAL wI1H 4-1/4-MN EI�DIT?T NM MIN GALWt✓ZED STEEL. 14. DFA SION LMOLNS SHALL CONFORM TO FEDERAL SPECI ICRION FF-S-=GROUP I.TYPE 4,GLASS 4 HL71 OFN BOLT I 17. ROUTE WNW COIIDUCIpiS ALONG 111E SIMEST NO STRAINTFST PAN POMP OR APPROVED EAUA.INSTALLATION SHALL E IN ACCORDANCE WITH THE MARFACTLREn RL701111001 ONS MINIMUM UM EMT IS DHENNSE NDWED LOW WOAD 08 E BENT AN RIRIY E>ZIEDMENT SHALL E THREE AND ONE HALF(3 11-4 NOES, AI RE ALM MADE a LEAST 12 MA ENDS#5WIE QW BE LOT A 0' RADIIS MIDI N EIMSM.LOND ANY MEDAL OBRCIS WITHIN 8 FEET OF PROJECT 10. GRAVEL SALE BASE AND CONCRETE SHALL BE RACED AGAINST UNDISTURBED SOD. ORO EIIIPRO1r OR QWIET TO MASTER GROUND EAR OR GROUNONG IING. 1L OWE IR16 TO==BARS GULL E MADE WITH RD HOLE OWNESSIOR IL CONCRETE FOR FENCE AND ICE BIDE SUPPORT SHALL E 3000 PSI AR ENTRAINED OX-M NORMAL WEIGHT CONCRETE TYPE OWPER LLIGS APPLY M E IIMIII G COMPOUND TO ALL LDOTIDI6 17. ALL CAST N PLACE CONCEIE SHALL E TOED AND RAGED IN ACCORDANCE WAIN THE REDILRMm115 B AC 318 ND 1a DOW)MUEINII MQNING 01VIC1E1s.COAIWIL CAGE OOUO CIS.AND ALM TO® AC 301. RACED WTR THE NM30 LAMA 20. APPLY OXIDE 1101 N N>OMPQIO TO ALL OWRE.S90H TYPE MUND CO I ECTI016 IL THE FOLLOWING MINIMUM CONCRETE WAR OVER RIFORCMNG STEEL SHALL E AS FOLLOWS UNLESS NOTED OT ER0L' CONCRETE CAST AGAINST EARTH_3 INCHES. 21. OONTRCTOR SKILL FROrOE MVO INSTAL OWI OIFCRONAL ELECTRONIC MOB SYSTEM CONC In EXPOSED TO FORM OR WAFR 00 BAILS DYER EACH OOUO MOD AND BOIpID PONIT BIMEEN ELOSTNG 10111W /8 AND LAROIR..._.............2 NOES MONBOIE GROU01IS RING AO EQUPIMIN OROAONG RIND. /5 NO SMALLER_.._..-._...1 1/2 INCHES 2L COWRW'IOR SAL TEST COMPLETED GROAN SYSTEM NO EM REUM FOR ALL EXPOSED EDGES SHALL E PROVIDED WITH A 3/4V/r CHAMFER UNLESS NOTED OIHERWM FMW QDSE-OUT DOCLOTAWR 5 ONES MOUIM RS6WICE REpURED. 2a OCNIRACIOR SKILL OONW AND LM REDIRN-LASS NO DISWICE- 19. LAMER SHALL=MY WITH TIE REOUROT] S OF THE NPAICAN INSTITUTE OF TWEET CONSTRICTION AND THE M1IONAL 104XU 01SUREMENIS;MS 1FSIS) REDCO RESULTS FOR PRO=QDE OUT. FMMT PRODUCTS ASSOCA110N'S TAIIOAL DESIGN SPECIFICATION FOR WOOD CONSTRUCTION. ALL IILMBFJt SHALL BE r PRESSURE TREATED AND SHALL E STRUCTURAL GRADE NO.2 OR ETFR. I DATE: 02/27/2017 HYMN N I5 SC10 MA LEASE EXHIBIT - - DRAWN BY: SMB N- ADVANCED ver��onwireiess DRAWING NUMBER REVISION CHECKED BY: SNA ENGINEERING GROUP, P.C. 115 MAIN STREET vER¢oN WIRELESS HYANNIS MA 02601 SCALE: AS NOTED Civil Engineering-Site Development 400 FRIBERG PARKWAY HYANNIS_SC 10_MA Surveying-Telecommunications WESTBOROUGH, MA 01.581 4 SHEET: 5 of 5 L - a m co q Ocvm f r �. .. i !.' _ � a � Y '' .. + Fa ✓. ' e � , _� i +5�}' 'h;.,1 a ,.